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Auyezkhankyzy D, Khojakulova U, Yessirkepov M, Qumar AB, Zimba O, Kocyigit BF, Akaltun MS. Nurses' roles, interventions, and implications for management of rheumatic diseases. Rheumatol Int 2024; 44:975-983. [PMID: 38693254 PMCID: PMC11108871 DOI: 10.1007/s00296-024-05603-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/22/2024] [Indexed: 05/03/2024]
Abstract
Nurses have become integral members of multidisciplinary teams in managing rheumatic diseases, departing from their traditional patient care roles. This article provides a comprehensive review of nurses' roles, interventions, and impacts in several rheumatic diseases, including rheumatoid arthritis, osteoarthritis, spondyloarthritis, gout, systemic lupus erythematosus, and polymyalgia rheumatica. It has been demonstrated that care under nursing supervision is effective and safe, with benefits including disease management, quality of life, and treatment adherence. In addition, nurses play a crucial role in promoting health, educating patients, and administering biological disease-modifying anti-rheumatic drugs. The COVID-19 pandemic has highlighted the significance of telehealth services and nurses' role in delivering remote care. However, nursing education and training challenges persist, particularly in standardization and access to postgraduate education. Efforts to enhance the role of nurses in rheumatology care are necessary to optimize patient outcomes and meet the evolving needs of individuals with rheumatic diseases. Collaboration across healthcare institutions, professional groups, and educational facilities is necessary for promoting the continual growth and advancement of rheumatology nurse practice. By equipping nurses with the requisite knowledge, expertise, and resources to deliver top-notch care, we can enhance the well-being of individuals with rheumatic diseases and foster improved overall health outcomes.
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Affiliation(s)
- Dana Auyezkhankyzy
- Department of Emergency Medicine and Nursing, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Umida Khojakulova
- Department of Emergency Medicine and Nursing, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Ainur B Qumar
- Department of Health Policy and Management, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Olena Zimba
- Department of Rheumatology, Immunology and Internal Medicine, University Hospital in Krakow, Kraków, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Türkiye
| | - Mazlum Serdar Akaltun
- Faculty of Medicine, Department of Physical Medicine and Rehabilitaton, Gaziantep University, Gaziantep, Türkiye.
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Lobo-Rodríguez C, Díaz-Redondo A, Chamorro-de-Vega E, Ais-Larisgoitia A, Ibares-Frias L, Baniandrés-Rodríguez O, Menchén L, González-Fernández CM. [Experience of patients with immune-mediated inflammatory diseases seen in a multidisciplinary integrated care unit]. J Healthc Qual Res 2024:S2603-6479(24)00039-3. [PMID: 38811300 DOI: 10.1016/j.jhqr.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/19/2024] [Accepted: 04/24/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE To describe the aspects with the greatest impact on the satisfaction of patients treated in a multidisciplinary unit specialising in immune-mediated inflammatory diseases (IMIDs) and to identify areas for improvement in the care model. METHODS Cross-sectional descriptive study using a satisfaction survey structured in three blocks: sociodemographic variables, functional aspects of the unit and satisfaction with the professionals. Immediate satisfaction was measured on aspects related to the care received, the physical structure and the likelihood of recommending the unit. RESULTS A total of 168 patients completed the surveys, the mean score of overall satisfaction with the unit was 4.75 (SD:0.4). The regression model showed the relationship between overall satisfaction and unit signage (OR:3.558, p=0.045, 95% CI: 1.027-12.33), coordination between professionals (OR:9.043, p=0.000, 95% CI: 2.79-29.28) and participation in decision making (OR: 44.836, p=0.000, 95% CI: 5.49-365.97). In terms of immediate satisfaction, the overall Net Promoter Score (NPS) was 87 (excellent). The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so they have been considered an area for improvement The mean score for coordination with Primary Care was 4.54 (SD:0.8) and they scored waiting time to be seen with 4.49 (SD:0.8), so both were considered areas for improvement. CONCLUSIONS Coordination between intra-centre professionals and patient participation in decision-making explain the excellent level of patient satisfaction. The monitoring of satisfaction has made it possible to implement immediate improvement actions.
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Affiliation(s)
- C Lobo-Rodríguez
- Departamento de Enfermería CEIMI, Hospital General Universitario Gregorio Marañón, Madrid, España; Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España.
| | - A Díaz-Redondo
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - E Chamorro-de-Vega
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A Ais-Larisgoitia
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Servicio de Farmacia CEIMI, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L Ibares-Frias
- Servicio de Farmacia CEIMI, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - O Baniandrés-Rodríguez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Servicio de Oftalmología CEIMI, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L Menchén
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Servicio de Gastroenterología CEIMI, Hospital General Universitario Gregorio Marañón, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - C M González-Fernández
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Servicio de Gastroenterología CEIMI, Hospital General Universitario Gregorio Marañón, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Wang Q, Cao Y. Nurse-supported care versus rheumatologist-led care in patients with rheumatoid arthritis at high disease activity: A retrospective study of two Chinese centers. Medicine (Baltimore) 2023; 102:e35398. [PMID: 37904451 PMCID: PMC10615497 DOI: 10.1097/md.0000000000035398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/05/2023] [Indexed: 11/01/2023] Open
Abstract
The European League Against Rheumatism recommendations for the management of rheumatoid arthritis advised the involvement of clinical nurses for the management of rheumatoid arthritis. However, The European League Against Rheumatism recommendations are difficult to apply to Chinese institutes. In China, the rheumatology nursing service is not widely adopted because the feasibility and quality of rheumatology nursing service have not been confirmed in the Chinese population by the Chinese authorities. The objectives of the study were to compare 2.5 years clinical outcomes of patients of rheumatoid arthritis (6 months history) with disease activity score 28-joint count with C-reactive protein (DAS28-CRP) > 5.1 who received nurse-supported care against those of patients who received rheumatologist-led care. Patients received 30 minutes/day and 6 times/week nurse-supported care (NC cohort, n = 127) or Patients had received 20 minutes session at every 3 months of conventional outpatient-based rheumatologist-led care (n = 131). Both types of care have involved the history of patients, care regarding effects and adverse effects of pharmacological treatments, patients education, overall well-being, everyday life, counseling, clarifications, and rehabilitation. Additionally, there were a cohort in which patients did not receive any nontreatment care (NN cohort, n = 141). All patients have definite depression and anxiety (hospital anxiety and depression scale Chinese version score ≥ 11) before nontreatment interventions. At 2.5 years of treatments with or without nontreatment interventions (EL) DAS28-CRP, depression, and anxiety scores of patients of the NC cohort were decreased as compared to their before any type of nontreatment interventions conditions and those of patients of the RC and NN cohorts at EL (P < .001 for all). At EL numbers of patients with moderate disease activity, (DAS28-CRP score: 3.2-5.1) and borderline depression and anxiety (hospital anxiety and depression scales Chinese version score: 8-10) were greater in the NC cohort than those of the RC and NN cohorts (P < .001 for all). Outpatient care satisfaction scores of patients of the NC cohort were higher than those of the RC [23 (27-17) vs 17 (21-14)] and NN [23 (7-17) vs 15 [18-12]) cohorts (P < .001 for both). Physiological and psychological conditions of patients with rheumatoid arthritis with DAS28-CRP > 5.1 are required to improve. Nurse-supported care is superior nontreatment compared to rheumatologist-led care in rheumatoid arthritis patients with high disease activity (Level of Evidence: IV; Technical Efficacy: Stage 5).
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Affiliation(s)
- Qian Wang
- Department of Rheumatology and Immunology Nursing, Sichuan Provincial People’s Hospital, The University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Department of Rheumatology and Immunology Nursing, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, Sichuan, China
| | - Yuqiong Cao
- Department of Rheumatology and Immunology Nursing, Sichuan Provincial People’s Hospital, The University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Department of Rheumatology and Immunology Nursing, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, Sichuan, China
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Song S. Effect observation and satisfaction analysis of rehabilitation nursing intervention in rheumatoid arthritis nursing. Panminerva Med 2023; 65:112-113. [PMID: 33263252 DOI: 10.23736/s0031-0808.20.04186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Suping Song
- Department of Nephropathy and Rheumatism, Jinan People's Hospital affiliated to Shandong First Medical University (Jinan City people's Hospital), Jinan, China -
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Healthcare Professionals' Compliance with the Standard Management Guidelines towards the Use of Biological Disease-Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084699. [PMID: 35457564 PMCID: PMC9025247 DOI: 10.3390/ijerph19084699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/30/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
Treatment of rheumatoid arthritis (RA) is complicated, with numerous aspects influencing decision-making, including disease severity, comorbidities, and patient preferences. The present study aimed to evaluate healthcare professionals' (HCPs) knowledge of biological disease-modifying anti-rheumatic drugs (bDMARDs) and their compliance with the standard management guidelines for assuring optimal RA therapy. The cross-sectional, survey-based study was performed in various healthcare and academic settings in Karachi, Pakistan to probe HCPs' knowledge of bDMARDs and their compliance with the European League against Rheumatism (EULAR) recommendations for the management of RA patients. Overall, n = 413 questionnaires were included in our study (response rate: 82.6%). The physicians were further well-informed about the indications (n = 276, 91.3%, p = 0.001) and monitoring requirements (n = 258, 85.4%, p = 0.004). The pharmacists were more knowledgeable about the drug targets (n = 96, 86.4%, p = 0.029) and their mechanisms of action (n = 80, 72.0%, p = 0.013). Male respondents as compared with females (41.3% vs. 35.6%, p = 0.04), and physicians as compared with pharmacists (40.7% vs. 37.8%, p = 0.012), were more confident in using bDMARDs than conventional treatment in RA patients. Our findings show that the respondents were familiar with the attributes of bDMARDs and the standard management guidelines for RA care. Our results may be relevant in creating new methods, guidelines, and treatments to enhance RA treatment adherence, satisfaction, and health outcomes.
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Epidemiology of rheumatic and musculoskeletal diseases in a Nigerian peri-urban community: results of a cross-sectional survey using the COPCORD stage 1 model. Reumatologia 2022; 60:366-375. [PMID: 36683835 PMCID: PMC9847106 DOI: 10.5114/reum.2022.123667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/28/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction There is relative neglect of rheumatic and musculoskeletal diseases (RMDs) in sub-Saharan Africa (SSA). While hospital-based reports on RMDs abound, there is a paucity of population-based reports on these conditions which are otherwise recognized to cause functional disability and reduced quality of life in the affected individuals. Thus, the objective of this study is to determine the prevalence, diagnostic types, and predictors of musculoskeletal (MSK) pain in Agbowa, a peri-urban community in Lagos, South-West Nigeria. Material and methods This community-based survey utilized the World Health Organisation/International League of Association of Rheumatology Community Oriented Programme for the Control of Rheumatic Diseases (WHO/ILAR COPCORD) stage 1 model. All respondents had their profiles documented via modified COPCORD questionnaires. Pain intensity and functional disability were assessed by the Numerical Rating Scale (NRS) and Health Assessment Questionnaires Disability Index (HAQ-DI) respectively. The rheumatic and musculoskeletal diseases were classified using relevant validated criteria. Data obtained were analysed using SPSS Version 21. Results There were 3056 respondents who were predominantly female (59.2%). The period prevalence of MSK pain among the 3056 respondents was 58% (n = 1,773). There were significantly more females with MSK pain than males (62.8% vs. 37.2%, p = 0.001). Overall, 380 (12.4%) subjects had clinically diagnosed RMDs. The common RMDs in decreasing order were osteoarthritis (n = 185, 6.1%), chronic low back pain (n = 95, 3.1%) and soft tissue rheumatism (n = 52, 1.7%). The bivariate analysis showed that female sex, family history of MSK conditions, history of previous trauma, and some comorbidities were significantly associated with MSK pain. The median HAQ-DI was 0.6 (IQR 0.1-1.8) with significant disability (HAQ-DI ≥ 1) in 39.5% of the subjects. Conclusions The burden and impacts of these conditions are considerable. Thus, the government needs to devise programmes and policies to limit the effects of RMDs in such communities.
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Sezgin MG, Bektas H. The effect of nurse-led care on fatigue in patients with rheumatoid arthritis: A systematic review and meta-analysis of randomised controlled studies. J Clin Nurs 2021; 31:832-842. [PMID: 34396605 DOI: 10.1111/jocn.16003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/19/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to investigate the effect of nurse-led care on fatigue in patients with rheumatoid arthritis. BACKGROUND Evaluating the effect of nurse-led care on fatigue in patients with rheumatoid arthritis will be useful in planning appropriate nursing interventions to increase the functional status and quality of life of patients. DESIGN Systematic review and meta-analysis. METHODS A comprehensive literature review was conducted on the Cochrane Library, Web of Science, PubMed, EBSCOhost/CINAHL Complete, Springer Link, ProQuest, Science Direct and Ovid databases. The selected articles were examined by two independent ratters with the PICOS criteria, and the methodological quality of the studies included in the study was evaluated with the Quality Assessment Tool for Quantitative Studies. The Comprehensive Meta-Analysis 3 software was used in the analysis of the data. The study was conducted using the checklist for PRISMA. RESULTS This meta-analysis study included six of 1,445 randomised controlled trials. These six studies consisted of a total of 994 patients and provided education and psychosocial support through 30-minute to 2-hour consultations, visits and briefings. No significant publication bias was found in the main outcomes. According to the results of the meta-analysis, the fatigue in patients with rheumatoid arthritis decreased significantly in nurse-led care groups compared with control groups (Hedge's g = -0.18; 95% CI = -0.3 to -0.06). CONCLUSIONS The findings in this systematic review and meta-analysis indicated that nurse-led care played an important role in reducing fatigue in patients with rheumatoid arthritis. RELEVANCE TO CLINICAL PRACTICE Nurse-led care is an effective and appropriate method in reducing fatigue in patients with rheumatoid arthritis. The awareness of all health professionals about the importance of nurse-led care will increase. We recommend the implementation of nurse-led education and psychosocial support interventions to reduce the fatigue of patients with rheumatoid arthritis.
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Affiliation(s)
- Merve Gozde Sezgin
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Hicran Bektas
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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孙 艳, 刘 健, 忻 凌, 周 琴, 陈 晓, 丁 香, 张 先. [The low expression of long non-coding RNA Linc00638 contributes to rheumatoid arthritis progression by regulating inflammation and oxidative stress]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:965-971. [PMID: 34308844 PMCID: PMC8329686 DOI: 10.12122/j.issn.1673-4254.2021.07.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the expression of long non-coding RNA (lncRNA) Linc00638 in rheumatoid arthritis (RA) and its regulatory role in inflammation and oxidative stress of synovial fibroblasts in RA patients (RA-FLS). METHODS Peripheral blood mononuclear cells (PBMCs) were collected from 20 healthy individuals and 35 RA patients for detecting the expression of Linc00638 using RT-qPCR to analyze the correlation of Linc00638 expression with the clinical indicators of RA patients. A Linc00638 overexpression plasmid and siRNA targeting Linc00638 were transfected into RA-FLS, and the changes in cell viability was observed using CCK8 assay; the changes in the expression levels of interleukin-4 (IL-4), IL-6, reactive oxygen species (ROS) and superoxide dismutase (SOD) in the supernatant were detected using ELISA. RESULTS Compared with the healthy control subjects, RA patients had significantly increased ESR, CRP, RF, anti-CCP, IgA, and C4 levels (P < 0.05) and significantly decreased Linc00638 expression in the PBMCs (P < 0.01). The area under the receiver-operating characteristic (ROC) curve of Linc00638 was 91.86% with the best cut-off value of 0.74 for diagnosis of RA. Spearman correlation analysis showed that Linc00638 expression level was negatively correlated with age, course of disease, DAS28, ESR, CRP, RF and anti-CCP, and positively correlated with IL-4 and SOD levels (P < 0.05). Association rule analysis showed that a decreased Linc00638 expression was strongly correlated with an increase of age (>60 years), a longer disease course (>10 years), elevated levels of ESR, RF and anti-CCP, and decreased levels of IL-4 and SOD. In RA-FLS, overexpression of Linc00638 significantly inhibited while Linc00638 interference obviously enhanced the cell viability. Over-expression of Linc00638 also significantly increased the levels of IL-4 and SOD (P < 0.05) and decreased the expressions of IL-6 and ROS (P < 0.05), while interference of Linc00638 produced the opposite effects in the cells (P < 0.05). CONCLUSION RA patients have low expression levels of Linc00638, which may participate in disease progression by regulating inflammation and oxidative stress.
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Affiliation(s)
- 艳秋 孙
- 安徽中医药大学研究生院,安徽 合肥 230031Graduate School of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
| | - 健 刘
- 安徽中医药大学第一附属医院风湿科,安徽 合肥 230031Department of Rheumatology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
| | - 凌 忻
- 安徽中医药大学第一附属医院信息中心,安徽 合肥 230031Information Center, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
| | - 琴 周
- 安徽中医药大学研究生院,安徽 合肥 230031Graduate School of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
| | - 晓露 陈
- 安徽中医药大学研究生院,安徽 合肥 230031Graduate School of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
| | - 香 丁
- 安徽中医药大学研究生院,安徽 合肥 230031Graduate School of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
| | - 先恒 张
- 安徽中医药大学研究生院,安徽 合肥 230031Graduate School of Anhui University of Traditional Chinese Medicine, Hefei 230031, China
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Abstract
Historically, rheumatic diseases have not received much attention in Africa, particularly in sub-Saharan Africa, possibly owing to a focus on the overwhelming incidence of infectious diseases and the decreased life span of the general population in this region. Global attention and support, together with better health policies and planning, have improved outcomes for many infectious diseases; thus, increasing attention is being turned to chronic non-communicable diseases. Rheumatic diseases were previously considered to be rare among Africans but there is now a growing interest in these conditions, particularly as the number of rheumatologists on the continent increases. This interest has resulted in a growing number of publications from Africa on the more commonly encountered rheumatic diseases, as well as case reports of rare diseases. Despite the limited amount of available data, some aspects of the epidemiology, genetics and clinical and laboratory features of rheumatic diseases in African populations are known, as is some detail on the use of therapeutics. Similarities and differences in these conditions can be seen across the multi-ethnic and genetically diverse African continent, and it is hoped that increased awareness of rheumatic diseases in Africa will lead to earlier diagnosis and better outcomes for patients. The prevalence of rheumatic diseases is increasing in African countries, leading to an increased need for specialist rheumatologists and disease-modifying drugs. In this Review, the authors outline what is currently known about the state of rheumatic diseases in Africa. In the past, there has been an emphasis on communicable diseases in Africa, but attention has now shifted towards non-communicable diseases such as rheumatic diseases. Common rheumatic diseases are seen in Africa and are both comparable and different from presentations seen outside of Africa. Diverse genetic and environmental factors affect the presentation of common rheumatic diseases among different African nations. A shortage of appropriately trained staff, laboratory testing capacity and effective medications exists across the whole continent. Advocacy and research are needed to increase awareness of the risk factors, presentations and management of rheumatic diseases in Africa. Specialized treatment guidelines are needed for resource-poor countries in Africa.
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Naveen R, Sundaram TG, Agarwal V, Gupta L. Teleconsultation experience with the idiopathic inflammatory myopathies: a prospective observational cohort study during the COVID-19 pandemic. Rheumatol Int 2020; 41:67-76. [PMID: 33150493 PMCID: PMC7640991 DOI: 10.1007/s00296-020-04737-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/21/2020] [Indexed: 01/26/2023]
Abstract
Teleconsultation has assumed a central role in the management of chronic and disabling rheumatic diseases, such as the idiopathic inflammatory myopathies (IIM), during COVID-19. However, the feasibility, challenges encountered, and outcomes remain largely unexplored. Here, we describe our teleconsultation experience in a prospectively followed cohort of adult and juvenile IIM. 250 IIM enrolled into the MyoCite cohort (2017-ongoing) were offered the option of audio/visual teleconsultation using WhatsApp during the nationwide lockdown. Clinical outcomes (major/minor relapse) and prescription changes were compared between IIM subsets. Socio-demographic and clinico-serological characteristics of those who sought teleconsultation were compared with those who did not. 151 teleconsultations were sought over a 93 day period by 71 (52.2%) of 136 IIM (median age 38 years, F:M 4.5:1). Nearly one-third (38%) consulted on an emergency basis, with voice consultations being the primary medium of communication. Over a quarter (26.8%) reported relapse (15.5% minor, 11.3% major), these being more common in JDM [71.4%, OR 8.9 (1.5-51)] as compared with adult IIM, but similar across various antibody-based IIM subtypes. Patients who relapsed required more consultations [2(2-3) vs 1(1-2), p 0.009]. The demographic and socioeconomic profile of the patients seeking consultation (n = 71) was not different from those who did not (n = 65). Voice-based teleconsultations may be useful to diagnose and manage relapses in IIM during the pandemic. Patient education for meticulous and timely reporting may be improve care, and larger multicentre studies may identify subsets of IIM that require greater care and early tele-triage for effective management of the condition.
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Affiliation(s)
- R Naveen
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - T G Sundaram
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Latika Gupta
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
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