PROMs: a novel approach to arthritis self-management.
ABSTRACT Despite our knowledge of many effective education techniques, there is little evidence that clinicians have incorporated them into their daily practices. One of the reasons for the underutilization of patient education may be that physicians are expecting the specialist nurses to provide this service, whereas the nurses lack any formal protocol for patient education in standard clinical practice. Self-management programmes are now acknowledged as a key element of quality care. A high priority for research is the development and diffusion of patient education strategies that are tailored to address patient needs and applicable for the standard day to day practice. This paper describes the rationale and design of the 'Joint Fitness Program' which is a new patient-based educational programme integrating patient-reported outcome measures (PROMs) and self-management for people with inflammatory arthritis. This education programme, which illustrates how theory can explicitly be translated into practice, addresses PROMs as an objective tool to assess the educational needs of patients with arthritis and uses the PROMs to design an education programme and not just evaluate the disease activity.
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ABSTRACT: There is a growing interest in psoriasis and psoriatic arthritis which moved from rather restricted and longstanding disease approach to a more comprehensive view, encompassing not only inflammatory back pain, but also peripheral arthritis, enthesitis, as well as co morbidities and extra-articular manifestations. The fact that psoriasis precedes joint disease in most patients provides an opportunity to identify those patients most likely to develop arthritis. The introduction of the “window of opportunity” concept into psoriatic arthritis management and the potential role of “early psoriatic arthritis” service to identify those suffering from active inflammatory disease have led to a significant change in the way these patients are managed. The recognition of a non-radiographic stage in early spondyloarthritis opened the door for imaging modalities such as MRI and US to book its place in the diagnosis of the pre-radiographic changes. This article will focus on recent developments in PsA pathogenesis, diagnostic strategies to identify patients with early psoriatic musculoskeletal inflammation in standard clinical practice and the implementation of patient reported outcome measures as well as imaging modalities for the diagnosis and management of the disease.
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ABSTRACT: There are several advantages in using patient-reported outcome measures (PROMs) in standard clinical practice, particularly if a questionnaire is distributed to each patient at each visit as a standard in the infrastructure usual care. The patients, being the most knowledgeable persons concerning their pain and global estimate, do most of the work by completing a questionnaire. Completion of the questionnaire helps the patients prepare for their visit as well as improving doctor-patient communication. Recently, the role of PROMs has expanded from the static phase of capturing and measuring outcomes at a single point of time to a more dynamic role. This dynamic role is aiming at driving improvement not only in the quality of inflammatory arthritis care but also in the patients' reported experience. Therefore, in addition to its value in tailoring treatment targets adapted to the patient's needs, PROMs also have the potential of modifying the disease impact through improving the patients' adherence to therapy and allowing the patients to monitor the changes in their condition. Though more attention has been given to the use of PROMs in routine clinical care, little was published regarding what could be done with the plethora of data gained from PROMs and how dynamic it can be enhancing the "patient-centered care" approach and improving patients' experience. This article highlights the value of adopting PROMs for arthritic patients in standard clinical practice and its impact on long-term patients' management.Clinical Rheumatology 04/2013; 32(6). DOI:10.1007/s10067-013-2228-0
Article: e-Rheumatology: Are We Ready?[Show abstract] [Hide abstract]
ABSTRACT: Advances in technology led to a heightened interest in exploring the use of this technology in the standard rheumatology practice. Tech-Talks will enable the information at the patients’ and rheumatologists’ fingertips. As e-rheumatology is an idea whose time has come, this review outlines the e-health’s developments and its impact on both the patients and the treating rheumatologists. Also it will discuss the strengths and weaknesses of using apps and mobile health in the day-to-day rheumatology service as well as the ethical and financial aspects of this model of care.Clinical Rheumatology 02/2015; 34(5). DOI:10.1007/s10067-015-2897-y