scholarly journals “Treat to Persist”, a deepening of the “Treat to Target”

2020 ◽  
pp. 4-6
Author(s):  
Gustavo Citera ◽  
Eduardo Mysler ◽  
Enrique R. Soriano
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Functional Capacity ◽  
Structural Damage ◽  
Primary Objective ◽  
Treat To Target ◽  
Basic Principles ◽  
Joint Decision

The treatment of rheumatoid arthritis (RA) has evolved considerably in recent years, resulting in a notable improvement in the functional capacity, quality and life expectancy of patients1. This improvement is not only due to the development of more and better medications, but mainly to the internalization by most rheumatologists of the concept of treat to target (T2T) or goal-directed treatment2. The T2T establishes 4 basic principles, which include: A) The treatment of rheumatoid arthritis must be based on a joint decision of the rheumatologist and the patient, B) The primary objective of the treatment of RA is to promote a good quality of life long-term, through the control of symptoms, prevention of structural damage, normalization of functional capacity and social participation of the patient, C) Suppression of inflammation is the main way to achieve these goals, D) Treatment towards a Objectively, evaluating disease activity and adjusting treatment accordingly, improves the outcome of RA patients.

scholarly journals Nurse-led care versus physician-led care in the management of rheumatoid arthritis and psoriatic arthritis (StaerkeR): study protocol for a multi-center randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Mai ◽  
Jürgen Braun ◽  
Jens-Peter Reese ◽  
Benjamin Westerhoff ◽  
Ulrike Trampisch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Patient Care ◽  
Functional Capacity ◽  
Standard Care ◽  
Controlled Trial ◽  
Treat To Target ◽  
Lower Saxony

Abstract Background In Germany, the care of patients with inflammatory arthritis could be improved. Although specialized rheumatology nurses could take over substantial aspects of patient care, this hardly occurs in Germany. Thus, the aim of the study is to examine structured nursing consultation in rheumatology practices. Methods/design In total, 800 patients with a stable course of rheumatoid arthritis or psoriatic arthritis in 20 centers in North Rhine–Westphalia and Lower Saxony will be randomized to either nurse-led care or standard care. Participating nurses will study for a special qualification in rheumatology and trial-specific issues. It is hypothesized that nurse-led care is non-inferior to standard care provided by rheumatologists with regard to a reduction of disease activity (DAS28) while it is hypothesized to be superior regarding changes in health-related quality of life (EQ-5D-5L) after 1 year. Secondary outcomes include functional capacity, patient satisfaction with treatment, and resource consumption. Discussion Since there is insufficient care of rheumatology patients in Germany, the study may be able to suggest improvements. Nurse-led care has the potential to provide more efficient and effective patient care. This includes a more stringent implementation of the treat-to-target concept, which may lead to a higher percentage of patients reaching their treatment targets, thereby improving patient-related outcomes, such as quality of life, functional capacity, and participation. Additionally, nurse-led care may be highly cost-effective. Finally, this project may form the basis for a sustainable implementation of nurse-led care in standard rheumatology care in Germany. Trial registration German Clinical Trials Register, DRKS00015526. Registered on 11 January 2019.

scholarly journals Measuring disease...

2019 ◽  
pp. 3-3
Author(s):  
María de los Ángeles Correa
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Targeted Therapy ◽  
Functional Capacity ◽  
Structural Damage ◽  
Therapeutic Management ◽  
Management Guidelines ◽  
Low Activity

Targeted therapy or T2T is the strategy recommended by the therapeutic management guidelines for patients with Rheumatoid Arthritis. As the name implies, treatment must be directed towards a particular goal and this goal is remission or low activity of the disease. Given the systemic compromise of this disease, we also evaluate other aspects of it such as quality of life, structural damage, functional capacity, fatigue, among others. To objectively measure all these aspects, we have numerous tools that allow us to measure the magnitude, extension or degree in terms of a certain standard of what one wishes to evaluate in the patient.

scholarly journals Long-term prognosis and quality of life in patients with early rheumatoid arthritis treated according to the 2015 ACR guideline (LELAND): protocol for a multicentre prospective observational study in Southern China

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023798
Author(s):  
Jinjun Zhao ◽  
Taihe Zhan ◽  
Junqing Zhu ◽  
Meida Fan ◽  
Qin Huang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Treat To Target ◽  
Early Ra ◽  
Long Term Prognosis

IntroductionRheumatoid arthritis (RA) is a chronic systemic disease and one of the most disabling diseases for patients. The American College of Rheumatology (ACR) issued a new guideline in 2015 for the treatment of RA based on the treat-to-target strategy to achieve better outcomes. This study will focus on the real-world rates of remission and low disease activity of patients with early RA in China, who will be treated according to the 2015 ACR guideline. Additionally, factors influencing treat-to-target outcomes will be analysed, and long-term prognosis and quality of life will be assessed.Method and analysisTwo-hundred patients with early RA will be enrolled, treated and followed up once every 3 months for 48 months. These patients should fulfil the 2010 RA classification criteria of the ACR/European League Against Rheumatism with a disease course of no more than 6 months and should also fulfil other eligibility criteria. The patients will be treated following the 2015 ACR guideline. Their disease activity will be assessed, and they will be instructed to complete several questionnaires once every 3 months. The primary outcomes are the Disease Activity Score on 28 joints and Health Assessment Questionnaire Disability Index. The secondary outcome variables are the Simplified Disease Activity Index, Clinical Disease Activity Index and Routine Assessment of Patient Index Data 3 results, imaging data and personal medical costs. The data will be analysed using appropriate statistical analyses.Ethics and disseminationThis research was approved by the Nanfang Hospital Ethics Committee (NFEC-2017–192). The results of the study will be published in international peer-reviewed journals.Trial registration numberNCT03508713; Pre-results.

Effects of treadmill training on the balance, functional capacity and quality of life in Parkinson’s disease: A randomized clinical trial

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Paria Arfa-Fatollahkhani ◽  
Afsaneh Safar Cherati ◽  
Seyed Amir Hasan Habibi ◽  
Gholam Ali Shahidi ◽  
Ahmad Sohrabi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Clinical Trial ◽  
Functional Capacity ◽  
Treadmill Training ◽  
Moderate Intensity ◽  
P Value ◽  
Short Term

AbstractBackgroundThere is growing evidence that exercise modalities have considerable effects on Parkinson’s disease (PD). This trial aimed to provide a more detailed viewpoint of short-term and long-term treadmill training (TT) effects on some motor and non-motor features of PD.MethodsIn this prospective, randomized, single-blind clinical trial, 20 mild to moderate PD patients, admitted in Rasoul-e-Akram hospital in Tehran, Iran, were randomly allocated in case (11) and control (9) groups. Treadmill intervention was performed at moderate intensity with 60% of heart rate reserved (HRR) in two 30-min sessions/week for a duration of 10 weeks. Both the groups were evaluated for three times; at the baseline, 2 months later and then 2 months after the second evaluation. We assigned the Timed Up and Go test (TUG), 6-min walk test (6MW), and the SF-8 healthy questionnaire, for assessment of balance, functional capacity, and Quality of life (QoL), respectively.ResultsBalance and functional capacity were significantly improved in the case group after the intervention (TUG p-value: 0.003, 6MW p-value: 0.003). Moreover, the long-term analysis revealed significant results as well (TUG p-value: 0.001, 6MW p-value: 0.004). Mental condition’s scores of SF-8 in cases were not statistically different in short-term follow-up (F/U). However, analysis illustrated p-value: 0.016 for long-term assessment. The intervention induced significant changes in physical condition’s scores in both of the F/Us (PC p-value: 0.013).ConclusionsThis study provides evidence that a TT of mild to moderate intensity has significant and persistent benefits for the balance, functional capacity, and QoL in PD.

scholarly journals The Rheumatoid Arthritis Quality of Life (RAQoL) for Indonesia: Translation and Pilot Test

INSIST ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 10
Author(s):  
Khoirunnisa S.M. ◽  
Perwitasari D.A
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Healthy Subjects ◽  
Primary Objective ◽  
Pilot Test ◽  
Validity And Reliability ◽  
Language Version ◽  
The Individual ◽  
The Uk

Abstract— The primary objective of this research were to produce and evaluate the official Indonesian language version of the Rheumatoid Arthritis Quality of Life instrument (RAQoL). The UK RAQoL was translated into Indonesian by a forward-backward translation. A separate lay panel was conducted to consider the appropriateness and comprehensibility of the items in Indonesian. The translated version of the RAQoL was pilot tested to determine whether the questionnaire RAQoL could be well understood and well accepted. Pilot test was conducted by interviews with 20 subjects, which 10 healthy Indonesia people and 10 rheumatoid arthritis patients who were recruited from X hospital in Yogyakarta, Indonesia.  Items on the two response format questionnaire used in pilot study were scored one for a ‘yes’ response and zero for a ‘no’ response. The individual total item scores with a high score indicating poor QoL. Few difficulties arose in the translation process and the new language version was well received by the lay panel and field-test participants. Statistical analysis was conducted to determine the difference of completion time between healthy subjects and RA patients, and the total score of the questionnaire answers between healthy subjects and patients. The average total score of responses to questionnaire on the healthy subject and patients by T test was significantly different (p < 0.05). The official Indonesian RAQoL was well received by RA patients. The psychometric quality of the translated questionnaire means that it is suitable for validity and reliability of the questionnaire towards patients with RA.Keywords—Rheumatoid Arthritis, questionnaire, RAQoL, translation, pilot test

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