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Nowell WB, Gavigan K, Garza K, O'Beirne R, Safford M, George M, Ogdie A, Walsh JA, Danila MI, Venkatachalam S, Stradford L, Rivera E, Curtis JR. Which Educational Topics and Smartphone App Functions Are Prioritized by US Patients With Rheumatic and Musculoskeletal Diseases? A Mixed-Methods Study. J Rheumatol 2024; 51:904-912. [PMID: 38749562 DOI: 10.3899/jrheum.2023-1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/17/2024]
Abstract
OBJECTIVE We sought to identify (1) what types of information US adults with rheumatic and musculoskeletal diseases (RMD) perceive as most important to know about their disease, and (2) what functions they would use in an RMD-specific smartphone app. METHODS Nominal groups with patients with RMD were conducted using online tools to generate a list of needed educational topics. Based on nominal group results, a survey with final educational items was administered online, along with questions about desired functions of a smartphone app for RMD and wearable use, to patients within a large community rheumatology practice-based research network and the PatientSpot registry. Chi-square tests and multivariate regression models were used to determine differences in priorities between groups of respondents with rheumatic inflammatory conditions (RICs) and osteoarthritis (OA), and possible associations. RESULTS At least 80% of respondents considered finding a rheumatologist, understanding tests and medications, and quickly recognizing and communicating symptoms to doctors as extremely important educational topics. The highest-ranked topic for both RIC and OA groups was "knowing when the medication is not working." The app functions that most respondents considered useful were viewing laboratory results, recording symptoms to share with their rheumatology provider, and recording symptoms (eg, pain, fatigue) or disease flares for health tracking over time. Approximately one-third of respondents owned and regularly used a wearable activity tracker. CONCLUSION People with RMD prioritized information about laboratory test results, medications, and disease and symptom monitoring, which can be used to create educational and digital tools that support patients during their disease journey.
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Affiliation(s)
- William B Nowell
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Kelly Gavigan
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York;
| | - Kimberly Garza
- K. Garza, PharmD, MBA, PhD, Auburn University, Harrison College of Pharmacy, Auburn, Alabama
| | - Ronan O'Beirne
- R. O'Beirne, EdD, Division of Continuing Medical Education, University of Alabama at Birmingham, Birmingham, Alabama
| | - Monika Safford
- M. Safford, MD, Division of General Internal Medicine, Weill Cornell Medicine, New York, New York
| | - Michael George
- M. George, MD, MSCE, A. Ogdie, MD, MSCE, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexis Ogdie
- M. George, MD, MSCE, A. Ogdie, MD, MSCE, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jessica A Walsh
- J.A. Walsh, MD, University of Utah, and George E. Wahlen Veterans Affairs Medical Center, Rheumatology, Salt Lake City, Utah
| | - Maria I Danila
- M.I. Danila, MD, MSc, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, and Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama
| | - Shilpa Venkatachalam
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Laura Stradford
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Esteban Rivera
- W.B. Nowell, MSW, PhD, K. Gavigan, MPH, S. Venkatachalam, MPH, PhD, L. Stradford, MPH, E. Rivera, MS, Global Healthy Living Foundation, Upper Nyack, New York
| | - Jeffrey R Curtis
- J.R. Curtis, MD, MS, MPH, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Sukhanova AM, Gilavian MA, Melnik EV, Shikh EV, Petukhov AE, Gegechkori VI, Dementev SP, Vlasov AM, Ramenskaya GV. An Overview of Adalimumab Therapy for Ankylosing Spondylitis. Curr Rheumatol Rev 2024; 20:501-513. [PMID: 38415452 PMCID: PMC11340288 DOI: 10.2174/0115733971289295240223095751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a chronic inflammatory disease known for causing pain, stiffness, and reduced mobility in the axial skeleton. Adalimumab, a tumor necrosis factor (TNF) inhibitor, has emerged as a promising therapeutic option for AS. METHODS This systematic review involved a comprehensive search of randomized controlled trials related to AS treatment, conducted in major databases such as MEDLINE, Google Scholar, and PubMed. The search terms encompassed ankylosing spondylitis, adalimumab, methotrexate, other non-biologic DMARDs, glucocorticoids, NSAIDs, and analgesics. A total of 14 randomized controlled trials with 4,500 participants were included in the review. RESULTS The review's results revealed that adalimumab demonstrated notable superiority when compared to a placebo. It effectively reduced disease activity, improved physical function, and lowered inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate. Adalimumab demonstrated a favorable safety profile, with adverse events comparable to those observed with placebo. CONCLUSION Based on the results, adalimumab is deemed an effective treatment for AS, showcasing its potential as a first-line therapeutic option. Notably, no significant increase in adverse events was observed compared to placebo. However, the conclusion emphasizes the need for further studies with extended follow-up durations to ascertain the long-term efficacy and safety of adalimumab in AS management. This systematic review provides valuable insights supporting the use of adalimumab in the treatment of AS and underscores the importance of ongoing investigations into its long-term effects to optimize its clinical utilization in AS patients.
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Affiliation(s)
- Anna M. Sukhanova
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 37/1 Lyublinskaya Str., 109390 Moscow, Russia
| | - Mariam A. Gilavian
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
| | - Elizaveta V. Melnik
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
| | - Evgenia V. Shikh
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
| | - Alexey E. Petukhov
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 37/1 Lyublinskaya Str., 109390 Moscow, Russia
| | - Vladimir I. Gegechkori
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
| | - Sergey P. Dementev
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
| | - Alexander M. Vlasov
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
| | - Galina V. Ramenskaya
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia;
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van der Kraan YM, Paap D, Lennips N, Veenstra ECA, Wink FR, Kieskamp SC, Spoorenberg A. Patients' Needs Concerning Patient Education in Axial Spondyloarthritis: A Qualitative Study. Rheumatol Ther 2023; 10:1349-1368. [PMID: 37523038 PMCID: PMC10469151 DOI: 10.1007/s40744-023-00585-7] [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: 05/15/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Within the EULAR recommendations, patient education (PE) is stated as the basis of the management of axial spondyloarthritis (axSpA). However, educational needs are scarcely qualitatively studied in axSpA. Therefore, we aimed to explore experiences and needs of PE in patients with axSpA. METHODS A phenomenological approach was used, with semi-structured in-depth interviews with patients with axSpA including broad variation in characteristics. Thematic analysis was applied. To enhance credibility, data saturation, research triangulation, peer debriefing, member checking, theoretical notes, and bracketing were performed. RESULTS Three interrelated themes regarding PE were identified from 20 interviews: illness perception, content, and 'availability'. Illness perception affects how patients experience and process PE, which consequently influences coping strategies. Prognosis, treatment, and coaching to self-management were identified as the most important content of PE. Regarding 'availability', face-to-face PE is preferred for exploring needs, supplemented by self-education, which can be freely applied. Additionally, sufficient time and a comprehensible amount of information were important and participants emphasized the need for axSpA-tailored information for relatives and friends. Participants reported a trusting patient-healthcare provider (HCP) relationship, and multidisciplinary and interdisciplinary attunement between HCPs as prerequisites for effective PE. CONCLUSIONS This first qualitative study exploring patients' experiences and needs of PE in axSpA revealed that prognosis, treatment, and coaching to self-management are important regarding content, and the combination of face-to-face contact and self-education the preferred modalities. It seems essential that patients' illness perceptions are taken into account for effective PE. These results add relevant insights for future PE guidelines in axSpA.
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Affiliation(s)
- Yvonne M van der Kraan
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands.
| | - Davy Paap
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
- Department of Physiotherapy, School of Health, Saxion University of Applied Sciences, 7513 AB, Enschede, The Netherlands
| | - Niels Lennips
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
| | - Else C A Veenstra
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
| | - Freke R Wink
- Department of Rheumatology, Medical Center Leeuwarden, 8934 AD, Leeuwarden, The Netherlands
| | - Stan C Kieskamp
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
| | - Anneke Spoorenberg
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands
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Kukafka R, Phang JK, Woon TH, Liew JW, Dubreuil M, Proft F, Ramiro S, Molto A, Navarro-Compán V, de Hooge M, Meghnathi B, Ziade N, Zhao SS, Llop M, Baraliakos X, Fong W. Social Media Use Among Members of the Assessment of Spondyloarthritis International Society: Results of a Web-Based Survey. J Med Internet Res 2023; 25:e39155. [PMID: 36626201 PMCID: PMC9875001 DOI: 10.2196/39155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The use of social media in health care may serve as a beneficial tool for education, information dissemination, telemedicine, research, networking, and communications. To better leverage the benefits of social media, it is imperative to understand the patterns of its use and potential barriers to its implementation in health care. A previous study in 2016 that investigated social media use among young clinical rheumatologists (≤45 years) and basic scientists showed that there was substantial social media use among them for social and professional reasons. However, there is a limited inquiry into social media use in different areas of rheumatology, such as spondyloarthritis. OBJECTIVE We aimed to explore the motivations, barriers, and patterns of social media use among an international group of experts in spondyloarthritis. METHODS We distributed a web-based survey via email from March 2021 to June 2021 to 198 members of the Assessment of Spondyloarthritis International Society. It contained 24 questions about demographic characteristics, patterns of current social media use, and perceptions of utility. Univariable and multivariable logistic regression analyses were performed to identify the characteristics associated with use trends. RESULTS The response rate was 78.8% (156/198). Of these, 93.6% (146/156) of participants used at least one social media platform. Apart from internet-based shopping and entertainment, the use of social media for clinical updates (odds ratio [OR] 6.25, 95% CI 2.43-16.03) and research updates (OR 3.45, 95% CI 1.35-8.78) were associated with higher social media consumption. Among the respondents, 66% (103/156) used social media in a work-related manner. The use of social media for new web-based resources (OR 6.55, 95% CI 2.01-21.37), interaction with international colleagues (OR 4.66, 95% CI 1.21-17.90), and establishing a web-based presence (OR 4.05, 95% CI 1.25-13.13) were associated with higher levels of consumption for work-related purposes. Time investment, confidentiality concerns, and security concerns were the top 3 challenges to a wider adoption of social media. CONCLUSIONS Most respondents (103/156, 66%) use social media in a work-related manner. Professional development, establishing a web-based presence, and international collaboration were associated with higher use. Challenges to social media adoption should be addressed to maximize its benefits.
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Affiliation(s)
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Ting Hui Woon
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Jean W Liew
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, United States
| | - Maureen Dubreuil
- Section of Rheumatology, Boston University School of Medicine, Boston, MA, United States
| | - Fabian Proft
- Division of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sofia Ramiro
- Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands
| | - Anna Molto
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | - Bhowmik Meghnathi
- Department of Rheumatology & Clinical Immunology, Marengo Care Institute of Medical Sciences Hospital, Ahmedabad, India
| | - Nelly Ziade
- Department of Rheumatology, Saint-Joseph University, Hotel-Dieu de France Hospital, Beirut, Lebanon
| | - Sizheng Steven Zhao
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Maria Llop
- Rheumatology, Parc Taulí Hospital Universitari, Sabadell, Spain
| | | | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-National University of Singapore Medical School, Singapore, Singapore.,National University of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Pachowsky ML, Morf H, Simon D, Schönau V, Valor-Mendez L, Knitza J, Fagni F, Engel K, Uder M, Hueber A, Schmidkonz C, Schett G, Kleyer A. Cinematic rendering in rheumatic diseases—Photorealistic depiction of pathologies improves disease understanding for patients. Front Med (Lausanne) 2022; 9:946106. [PMID: 35991672 PMCID: PMC9387553 DOI: 10.3389/fmed.2022.946106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPatient education is crucial for successful chronic disease management. Current education material for rheumatic patients however rarely includes images of disease pathologies, limiting patients’ disease understanding. Cinematic rendering (CR) is a new tool that allows segmentation of standard medical images (DICOMs) into pictures that illustrate disease pathologies in a photorealistic way. Thus CR has the potential to simplify and improve the explanation of disease pathologies, disease activity and disease consequences and could therefore be a valuable tool to effectively educate and inform patients about their rheumatic and musculoskeletal disease (RMD).ObjectivesTo examine the feasibility of creating photorealistic images using CR from RMD patients depicting typical rheumatic disease pathologies and, in a second step to investigate the patient-perceived educational potential of these photorealistic images in clinical routine.MethodsWe selected conventional, high-resolution (HR) and positron emission tomography (PET) computed tomography (CT) images of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (axSpA), and giant cell arteritis (GCA) that showed typical respective disease pathologies. These images were segmented using CR technique. In a prospective study, physicians used CR-enhanced and conventional original images to explain the depicted pathognomonic pathologies to patients with the respective rheumatic disease. Patients were then asked to complete a questionnaire evaluating the perceived usefulness of being presented with CR-enhanced images to better understand their underlying disease.ResultsCR images were successfully generated from above mentioned CT methods. Pathologies such as bone erosions, bony spurs, bone loss, ankylosis, and PET-based inflammation could be visualized in photorealistic detail. A total of 79 patients (61% females) with rheumatic diseases (RA 29%, PsA 29%, axSpA 24%, GCA 18%) were interviewed and answered the quantitative questionnaire. Mean age was 55.4 ± 12.6 years. Irrespective of disease, all patients agreed or highly agreed that CR-based images help to improve disease understanding, should be shown at disease onset, provide a rationale to regularly take medication and would like to have access to their own CR-enhanced images.ConclusionConventional disease images can successfully be turned into photorealistic disease depictions using CR. Patients perceived CR images as a valuable addition to current patient education, enabling personalized disease education and potentially increased medication adherence.
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Affiliation(s)
- Milena L. Pachowsky
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Harriet Morf
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Verena Schönau
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Larissa Valor-Mendez
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Johannes Knitza
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Filippo Fagni
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Michael Uder
- Institute of Radiology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Axel Hueber
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Division of Rheumatology, Klinikum Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | - Christian Schmidkonz
- Department of Nuclear Medicine, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Industrial Engineering and Health, Technical University of Applied Sciences Amberg-Weiden, Weiden, Germany
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- *Correspondence: Arnd Kleyer,
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Brolin S, Welin E, Lövström B, Bruchfeld A, Gunnarsson I, Pettersson S. Exploring the educational needs of patients with systemic vasculitis using the educational needs assessment tool. Rheumatol Adv Pract 2022; 6:rkac062. [PMID: 35993015 PMCID: PMC9382267 DOI: 10.1093/rap/rkac062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/15/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Knowledge and health literacy enable patients to monitor symptoms and disease impact. Educational needs have previously been explored in rheumatology, but scarcely for patients with ANCA-associated vasculitis (AAV). The aim of the study was to assess the educational needs among patients with AAV using the educational needs assessment tool (ENAT).
Methods
This was a cross-sectional observational study including adults with AAV. Educational needs were captured by ENAT. Total ENAT (0–117 points, with higher numbers indicating higher educational need) and the seven domains (managing pain, movement, feelings, disease process, treatment, self-management and support systems) were explored regarding sex, age, education, diagnosis, disease duration and disease activity. To compare domains, a percentage response (0–100%) was calculated.
Results
One hundred and seventy-eight individuals (50% men; 34% with disease duration ≤2 years) were included. The total ENAT mean was 66.5 (s.d. 26.6; 57%), with domains as follows: disease process, 78%; self-management, 69%; treatments, 64%; feelings, 56%; managing pain, 48%; support systems, 47%; and movement, 41%. Higher educational needs were found among women in the domains movement, feelings and disease process and in total ENAT (all P < 0.04) compared with men. Higher educational needs were also seen in patients with disease duration ≤2 years regarding disease process, self-management and support systems and in total ENAT compared with patients with longer disease duration (all P < 0.03).
Conclusion
This study revealed great educational needs among AAV patients. Some groups expressed higher needs (women and those with shorter disease duration). Increased education for patients with AAV might lead to improved self-care and treatment adherence.
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Affiliation(s)
- Sara Brolin
- Department of Rheumatology, Karolinska University Hospital
- Department of Medicine Solna, Karolinska Institutet, Stockholm
| | | | - Björn Lövström
- Department of Rheumatology, Karolinska University Hospital
- Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Annette Bruchfeld
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping
- Department of Renal Medicine, Karolinska University Hospital
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Iva Gunnarsson
- Department of Rheumatology, Karolinska University Hospital
- Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Susanne Pettersson
- Correspondence to: Susanne Pettersson, Department of Medicine, Solna, Rheumatology Unit, Karolinska Instiutet, 171 77 Stockholm, Sweden. E-mail:
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Gavigan K, Nowell WB, Hunter T, Curtis JR, Malatestinic WN, Bolce RJ, Lisse JR, Walsh J. Employment, Work Productivity, and Biologic Treatments in Self-Reported Axial Spondyloarthritis: a Cross-Sectional Study in a Female Predominant Population from the ArthritisPower Registry. Rheumatol Ther 2022; 9:663-677. [PMID: 35191010 PMCID: PMC8964841 DOI: 10.1007/s40744-022-00428-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The aim of this study was to characterize employment, work productivity, and biologic disease-modifying anti-rheumatic drug (bDMARD) treatment in a predominantly female population of axial spondyloarthritis (axSpA) patients in a real-world setting. METHODS This was a cross-sectional study of axSpA participants within the ArthritisPower registry. Outcomes were assessed with surveys (Work Productivity and Activity Impairment [WPAI], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], and Patient-Reported Outcomes Measurement Information System instruments) and compared between subgroups (employed vs. not employed; taking vs. not taking a bDMARD). RESULTS Among the 195 participants, 117 (60.0%) were employed and 78 (40.0%) were not employed entirely or partially due to axSpA. The mean age of the participants was 47.6 years and 86.7% were female. Current bDMARD use was reported by 57.4% of those surveyed (59.8% employed vs. 53.9% not employed; p = 0.408). Compared to not employed participants, employed participants had more favorable disease activity (BASDAI 6.0 vs. 7.6; p < 0.001) and overall health (self-rated health 2.5 vs. 1.8; p < 0.001). Employed participants, compared to not employed participants, were diagnosed at an earlier age (36.0 vs. 42.5 years, respectively) and experienced a shorter time between symptom onset and diagnosis (9.5 vs. 13.6 years, respectively). Employed participants reported missing on average 6.5 days of work and experienced a 52.7% impairment on work productivity due to axSpA over a 3-month period. Absenteeism and presenteeism were statistically similar between participants taking a bDMARD versus those not taking a bDMARD. CONCLUSIONS Although bDMARD treatment rates were similar between employed and not employed participants, disease activity and overall health were better in employed than non-employed participants. Employed participants experienced substantial work productivity impairment due to axSpA.
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Affiliation(s)
- Kelly Gavigan
- Global Healthy Living Foundation, 515 N Midland Ave, Upper Nyack, NY, 10960, USA.
| | - W Benjamin Nowell
- Global Healthy Living Foundation, 515 N Midland Ave, Upper Nyack, NY, 10960, USA
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Nowell WB, Gavigan K, Hunter T, Malatestinic WN, Bolce RJ, Lisse JR, Himelein C, Curtis JR, Walsh JA. Treatment Satisfaction and Decision-making from the Patient Perspective in Axial Spondyloarthritis: Real-World Data from a Descriptive Cross-sectional Survey Study from the ArthritisPower Registry. ACR Open Rheumatol 2021; 4:85-94. [PMID: 34758105 PMCID: PMC8754015 DOI: 10.1002/acr2.11365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 01/17/2023] Open
Abstract
Objective Aims were to 1) to characterize patient decision‐making with treatment for axial spondyloarthritis (axSpA) and 2) to explore relationships among decision‐making, treatment satisfaction, and biologic disease modifying antirheumatic drugs (bDMARDs). Methods ArthritisPower participants with physician‐diagnosed axSpA were invited to complete an online survey about their treatment and their most recent physician visit. Analysis compared treatment decision by satisfaction and bDMARD status. Results Among the 274 participants, 87.2% were female, and the mean age was 50 years. Of participants, 79.5% had researched treatment before their most recent physician visit, and 56.9% discussed treatment change at their most recent physician visit. Of treatment‐change discussions, 69.2% of them were related to escalation, compared with deescalation (27.6%) and/or switching (39.1%). Among those participants who discussed a change, 73.7% agreed to it because they felt that their disease was not being controlled (54.9%) or felt that it could be better controlled on new treatment (20.3%). Top symptoms prompting change were back/buttock pain (63.3%), other joint pain (55.1%), and fatigue (54.1%). Among bDMARD‐treated participants (n = 128), important factors for treatment decisions were prevention of long‐term axSpA consequences (92.9%) and doctor's advice (87.5%). Among 43.4% of participants reporting treatment dissatisfaction, 37% did not discuss treatment change. Current bDMARD use was more common in satisfied (61.9%) than dissatisfied participants (26.9%). Conclusion In this cross‐sectional study of a predominantly female axSpA population, patients frequently researched treatment options and discussed escalation with their providers. Under two‐thirds of participants who were dissatisfied with treatment discussed changes at their most recent visit. Current bDMARD use was associated with higher satisfaction, and bDMARD users considered prevention of long‐term consequences and doctor's advice to be very important for decision‐making.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jessica A. Walsh
- University of UtahSalt Lake CityUtah
- George E. Wahlen Veterans Affairs Medical Center, RheumatologySalt Lake CityUtah
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Kaya T, Atıcı P, Karatepe AG, Günaydın R. Peer-led education or booklet for knowledge transfer about disease: A randomized-controlled trial with ankylosing spondylitis patients. Arch Rheumatol 2021; 36:560-569. [PMID: 35382377 PMCID: PMC8957762 DOI: 10.46497/archrheumatol.2021.8334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 03/06/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives
This study aims to investigate whether peer-led group education + booklet is superior to booklet only to increase ankylosing spondylitis (AS) patients’ knowledge about their disease. Patients and methods
A total of 56 patients (46 males, 10 females; mean age 41.9±9.2 years; range, 22 to 58 years) with a definite diagnosis of AS who were under follow-up in our outpatient clinic between August 2010 and January 2012 were included in this study. The patients were randomly allocated to the peer-led education + booklet (education group, n=27) and booklet only (control group, n=29). To assess the level of patients’ knowledge, a patient knowledge questionnaire containing four domains was used. Evaluations were made at baseline, four weeks, and six months. The variables were “number of correct choices” (NoCC), “number of correct items” (NoCI) and percent of correct choices for each domain; the later one was resembled by the name of that domain (area A, area B, etc.). Results
The variables that improved in both groups were NoCC, NoCI, and “pharmacotherapy and physical therapy area” (area C). These improvements were similar between the groups (respectively, p=0.915, p=0.830, p=0.791). Conclusion
Reading a booklet alone is as successful as peer-led education + booklet for knowledge transfer about their disease in patients with AS. In this study, the most knowledge gain was achieved in “drug treatment and physical therapy” area.
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Affiliation(s)
- Taciser Kaya
- Department of Physical Medicine and Rehabilitation, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Pınar Atıcı
- Department of Physical Medicine and Rehabilitation, Nevşehir State Hospital, Nevşehir, Turkey
| | - Altınay Göksel Karatepe
- Department of Physical Medicine and Rehabilitation, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Rezzan Günaydın
- Department of Physical Medicine and Rehabilitation, Medical Park Izmir Hospital, Izmir, Turkey
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Song Y, Chen H. Evaluating Chinese Mobile Health Apps for Ankylosing Spondylitis Management: Systematic App Search. JMIR Mhealth Uhealth 2021; 9:e27234. [PMID: 34259644 PMCID: PMC8319772 DOI: 10.2196/27234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/01/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients with ankylosing spondylitis (AS), a chronic systematic inflammatory disease, require long-term treatment and management. Mobile health (mHealth) apps can deliver health services through mobile devices, facilitate long-term disease management, support patient-health care provider communication, and enable patients to engage in disease management. There are some apps targeted at patients with AS, but the feature and quality of these apps have not been systematically examined. OBJECTIVE The aim of this study was to identify existing, publicly available Chinese mHealth apps for AS management and to evaluate their features and quality. METHODS We systematically searched potential apps for AS management on the Apple and Huawei App Stores, using 4 search terms: ankylosing spondylitis, spondyloarthritis, rheumatic disease, and arthritis. Apps were included if they were in the Chinese language, targeted at patients with AS, could be downloaded and run on Android and/or iOS operating systems, and incorporated elements of disease management and/or patient education. We excluded apps that were not for patient use, not relevant to AS, or had not been updated since 2018. Apps that met the inclusion criteria were downloaded for final analysis. We formulated a list of app quality measures from and consistent with international guidelines for mHealth apps and AS management to evaluate the features and quality of the included app. The user version of the Mobile App Rating Scale (uMARS) was also used to rate the apps' quality. RESULTS Of the 354 apps screened, 5 met the inclusion criteria and were included in our analysis. All apps were free, and most apps (4/5, 80%) had a privacy policy. Of the 5 apps, 1 (20%) involved medical professionals in the development process, 2 (40%) were developed by companies, and 2 (40%) were developed by medical institutions. All apps provided educational information about AS. Around half of the apps had functions like a basic information record (ie, users can input gender, age, disease history, etc) (n=3, 60%), patient-health care provider (and patient-patient) communication (n=2, 40%), symptom tracking (n=2, 40%), and information sharing (n=3, 60%). Only 1 (20%) app provided comprehensive functions that adhered to international guidelines for AS management and mHealth apps. The overall uMARS scores ranged from 2.7 to 4.2; only 1 app, with an overall uMARS score of 4.2, was considered as a high-quality app. CONCLUSIONS Most apps lacked comprehensive functions for AS management. One high-quality app provided comprehensive functions to help patients manage their conditions. This study assessed and summarized the features and quality of the apps but did not evaluate their efficacy. Future studies should evaluate the feasibility and efficacy of these apps. International guidelines and regulations for the design, development, validation, and implementation of mHealth apps are needed in the future. Meanwhile, health care providers, patients with AS, and app developers should collaborate to develop high-quality, evidence-based apps that take into account patients' needs and health care professionals' perspectives.
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Affiliation(s)
- Yuqing Song
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
| | - Hong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
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11
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Alahmari ASA, Qari SK, Asiri RI, Almohammadi TA, Alalawi MA, Aljahdali HM, Alnasser AH, Alaqeel FA, Kazim OA, Qasem HAO. An Overview on the Role of Surgical Management in Ankylosing Spondylitis. ARCHIVES OF PHARMACY PRACTICE 2021. [DOI: 10.51847/9azbvu4zlt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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12
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Pedley R, Dean LE, Choy E, Gaffney K, Ijaz T, Kay L, Lovell K, Molloy C, Martin K, Packham J, Siebert S, Sengupta R, Macfarlane GJ, Hollick RJ. Feasibility, acceptability and change in health following a telephone-based cognitive behaviour therapy intervention for patients with axial spondyloarthritis. Rheumatol Adv Pract 2020; 5:rkaa063. [PMID: 34222775 PMCID: PMC8248414 DOI: 10.1093/rap/rkaa063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/08/2020] [Indexed: 11/14/2022] Open
Abstract
Objective The aim was to assess the feasibility and acceptability of a telephone-based cognitive behaviour therapy (tCBT) intervention for individuals with axial SpA (axSpA), with and without co-morbid FM, and to measure the change in patient-reported health outcomes. Methods A convenience sample of individuals recruited from British Society for Rheumatology Biologics Registry for AS (BSRBR-AS) sites were offered a course of tCBT (framed as coaching). Patient-reported outcomes were measured at baseline and on course completion. Semi-structured qualitative interviews assessed intervention acceptability. Thematic analysis was informed by the theoretical framework of acceptability. Results Forty-two participants attended for initial assessment. Those completing at least one tCBT session (n = 28) were younger, more likely to meet classification criteria for FM (57 vs 29%) and reported higher disease activity. Modest improvements were reported across a range of disease activity and wider health measures, with 62% of patients self-rating their health as improved (median 13 weeks post-intervention). Twenty-six participants were interviewed (including six who discontinued after initial assessment). tCBT was widely acceptable, offering a personalized approach. Despite low or unclear expectations, participants described improved sleep and psychological well-being and gained new skills to support self-management. Reasons for non-uptake of tCBT centred on lack of perceived need and fit with individual value systems. Many felt that tCBT would be most useful closer to diagnosis. Conclusion Higher uptake among axSpA patients with co-morbid FM suggests that these individuals have additional needs. The findings are helpful in identifying patients most likely to engage with and benefit from tCBT and to maximize participation.
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Affiliation(s)
- Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester
| | - Linda E Dean
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen
| | - Ernest Choy
- CREATE Centre, Section of Rheumatology, Division of Infection and Immunity, Cardiff University, Cardiff
| | - Karl Gaffney
- Department of Rheumatology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich
| | - Tanzeel Ijaz
- Hywel Dda University Health Board, Haverfordwest
| | - Lesley Kay
- Rheumatology Department, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester
| | - Christine Molloy
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester
| | - Kathryn Martin
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen
| | - Jonathan Packham
- Haywood Rheumatology Centre, Stoke on Trent.,Division of Epidemiology and Public Health, University of Nottingham
| | - Stefan Siebert
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow
| | - Raj Sengupta
- Royal National Hospital for Rheumatic Diseases, Royal United Hospitals NHS Foundation Trust.,Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Gary J Macfarlane
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen
| | - Rosemary J Hollick
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen
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13
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The journey of the non-radiographic axial spondyloarthritis patient: the perspective of professionals and patients. Clin Rheumatol 2020; 40:591-600. [PMID: 32632698 DOI: 10.1007/s10067-020-05269-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/17/2020] [Accepted: 06/26/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Explore the perspective of patients and professionals regarding non-radiographic axial spondyloarthritis (nr-axSpA) and to define the patient's journey from diagnosis to treatment in order to identify unmet needs during the process. METHODS A qualitative study was carried out in two phases. In the first part, five focus groups were held with rheumatologists, orthopaedist, physiotherapists, primary care physicians (PCP), radiologists and six narrative interviews with nr-axSpA patients. In the second part, a nominal group meeting was held to detect which needs were not covered in the nr-axSpA (all of whom had collaborated in the previous phase). RESULTS The topics discussed with professional groups and patients were the appropriateness of the term and concept of nr-axSpA, the management of low back pain and inflammatory back pain in routine clinical practice, complementary test and the problem of waiting lists and finally the unmet needs both from a practitioner's and a patient's perspective. The final group explored solutions to the problems based on what was discussed in the first part of the project. Some of these solutions were strengthening relations between specialties, implementing high resolution consultations, rethinking the disability scales, offering better information to patients, designing resource maps and using different strategies to promote knowledge of the disease. CONCLUSION Many different perspectives on the same disease have revealed the difficult journey of the patient with suspected nr-axSpA, while identifying problems and solutions. Key Points • Diagnosis of nr-AxSpA among health professionals outside rheumatology may lead to numerous turns and difficulties in the patient's journey. • The impact of delays and complications in the journey to diagnosis is not quantified but directly affects the state of well-being and health of patients. • Multidisciplinary care is far from a reality. Primary care (key specialists in any chronic condition), radiologists, orthopaedists, and non-physicians such as physiotherapists and psychologists are generally excluded from dealing with these patients, and often have to do their work outside of physicians, rather than working together in a truly patient-centred medicine.
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14
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Ibáñez Vodnizza SE, van Bentum RE, Valenzuela O, van der Horst-Bruinsma IE. Patients with axial spondyloarthritis report significant differences between men and women and high impact of the disease: Large websurvey analysis. Joint Bone Spine 2020; 87:315-319. [PMID: 32109577 DOI: 10.1016/j.jbspin.2020.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/12/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE In axial spondyloarthritis (axSpA), mounting evidence shows female patients to experience a higher disease burden. These differences appear to be particularly large in South America. One explanation could be inequity in treatment access between men and women. The objective was to evaluate gender differences in disease burden and work participation, and the potential influence of treatment, in Latin American patients. METHODS A cross sectional online survey among axSpA patients, collecting disease characteristics, treatment, disease burden (BASDAI, BASFI, ASAS Health Index) and work participation (WPAI). Associations between gender and disease burden or work participation were assessed through regression analyses, correcting for treatment. RESULTS AxSpA was reported by 472 participants (63% women) and disease activity (BASDAI≥4: 83%), ASASHI (≥moderately impaired: 91%) and work disability (absenteeism: 41%; presenteeism 82%) were high. Biological use was very low (20%), while 34% used opiates. Females had significantly higher BASDAI, ASAS HI, work absenteeism and presenteeism, although were less likely to receive biologics (26% versus 16%, P<0.01). Gender differences disappeared after correction for treatment. CONCLUSIONS This web survey in Latin American axSpA patients shows a high disease burden and work impairment. The use of biologics is low, while the use of opiates was alarmingly high. Women used significantly less biologics despite reporting a worse disease state and work disability, which could be due to treatment inequity.
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Affiliation(s)
- Sebastian E Ibáñez Vodnizza
- Department of Rheumatology, Clínica Alemana, Universidad del Desarrollo medicine Faculty, 1410, Av. Manquehue Norte, 7650567 Vitacura, Santiago, Chile.
| | - Rianne E van Bentum
- Department of Rheumatology, Amsterdam University Medical Center, location VUmc, 1117, De Boelelaan, 1081HV Amsterdam, Netherlands
| | - Omar Valenzuela
- Department of Rheumatology, Clínica Alemana, Universidad del Desarrollo medicine Faculty, 1410, Av. Manquehue Norte, 7650567 Vitacura, Santiago, Chile
| | - Irene E van der Horst-Bruinsma
- Department of Rheumatology, Amsterdam University Medical Center, location VUmc, 1117, De Boelelaan, 1081HV Amsterdam, Netherlands
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15
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Dzubur E, Khalil C, Almario CV, Noah B, Minhas D, Ishimori M, Arnold C, Park Y, Kay J, Weisman MH, Spiegel BMR. Patient Concerns and Perceptions Regarding Biologic Therapies in Ankylosing Spondylitis: Insights From a Large-Scale Survey of Social Media Platforms. Arthritis Care Res (Hoboken) 2019; 71:323-330. [PMID: 29781587 DOI: 10.1002/acr.23600] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Few studies have examined ankylosing spondylitis (AS) patients' concerns about and perceptions of biologic therapies, apart from traditional surveys. In this study, we used social media data to examine the knowledge, attitudes, and beliefs of AS patients regarding biologic therapies. METHODS We collected posts published on 601 social media sites between January 1, 2016 and April 26, 2017. In each post, both an AS keyword and a biologic were mentioned. To explore themes within the collection of posts in an unsupervised manner, a latent Dirichlet allocation topic model was fit to the data set. Each discovered topic was represented as a discrete distribution over the words in the collection, similar to a word cloud. The topics were manually reviewed to identify themes, which were confirmed using thematic data analysis. RESULTS We examined 27,416 social media posts and identified 112 themes. The majority of themes (n = 67 [60%]) focused on discussions related to AS treatment. Other themes, including the psychological impact of AS, reporting of medical literature, and AS disease consequences, accounted for the remaining 40% (n = 45). In discussions regarding AS treatment, most topics involved biologics, and most subthemes involved side effects (e.g., fatigue, allergic reactions), biologic treatment attributes (e.g., dosing, frequency), and concerns about use of biologics (e.g., increased cancer risk). Additional implicit patient needs (e.g., support) were identified using qualitative analyses. CONCLUSION Social media revealed a dynamic range of themes governing AS patients' experience with and choice of biologic agents. The complexity of selecting biologics from among many such agents and navigating their risk/benefit profiles suggests the merit of creating online tools tailored to support patients' decision-making with regard to biologic therapies for AS.
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Affiliation(s)
- Eldin Dzubur
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Carine Khalil
- Cedars-Sinai Medical Center and Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, California
| | - Christopher V Almario
- Cedars-Sinai Medical Center and Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, California
| | - Benjamin Noah
- Cedars-Sinai Medical Center and Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, California
| | - Deeba Minhas
- Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Corey Arnold
- Medical Imaging Informatics, University of California, Los Angeles
| | - Yujin Park
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Jonathan Kay
- University of Massachusetts Memorial Medical Center and University of Massachusetts Medical School, Worcester
| | | | - Brennan M R Spiegel
- Cedars-Sinai Medical Center and Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, California
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Ogdie A, Benjamin Nowell W, Reynolds R, Gavigan K, Venkatachalam S, de la Cruz M, Flood E, Schwartz EJ, Romero B, Park Y. Real-World Patient Experience on the Path to Diagnosis of Ankylosing Spondylitis. Rheumatol Ther 2019; 6:255-267. [PMID: 31041666 PMCID: PMC6513959 DOI: 10.1007/s40744-019-0153-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction We describe the journey to diagnosis of ankylosing spondylitis (AS) from the patient perspective and examine differences in this journey by sex. Methods US adults aged ≥ 18 years with a self-reported AS diagnosis were recruited online through CreakyJoints, a patient support community, and ArthritisPower, a patient research registry. Respondents completed a web-based survey on sociodemographics, disease burden, and diagnosis history. Results were stratified by sex and time to diagnosis using two-sample t tests and χ2 tests, respectively, to observe differences across the groups; P < 0.05 was considered statistically significant. Results Among 235 respondents, 174 (74.0%) were female. Mean (SD) ages of female and male respondents were 48.6 (10.6) and 53.1 (10.3) years, respectively. From the time respondents began seeking medical attention, 87 were diagnosed within ≤ 1 year, 71 in 2–9 years, and 77 after ≥ 10 years. Symptoms that led respondents to seek treatment were back pain (73.2%) and joint pain (63.8%); fatigue and difficulty sleeping were more common among respondents with longer times to diagnosis. During the diagnosis process, men with AS tended to receive quicker AS diagnosis compared with women. Overall, commonly reported initial diagnoses among respondents with longer time to AS diagnosis included back problems and psychosomatic disorders. Significantly more women reported misdiagnoses of fibromyalgia (20.7 vs. 6.6%) and psychosomatic disorders (40.8 vs. 23.0%) compared with men. Conclusions Diagnosis delays and misdiagnoses were common among respondents with AS. Increasing awareness about AS among referring providers may minimize diagnosis delay. Funding Novartis Pharmaceuticals Corporation. Plain Language Summary Plain language summary available for this article. Electronic Supplementary Material The online version of this article (10.1007/s40744-019-0153-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexis Ogdie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | | | | | - Kelly Gavigan
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | | | | | | | | | | | - Yujin Park
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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17
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Yim SJ, Park YB, Kim J, Park SH. Long-term Outcomes of Cemented Total Hip Arthroplasty in Patients with Ankylosing Spondylitis at a Minimum Follow-up of 10 Years. Hip Pelvis 2018; 30:175-181. [PMID: 30202752 PMCID: PMC6123511 DOI: 10.5371/hp.2018.30.3.175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/29/2018] [Accepted: 06/06/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose This study was performed to evaluate long-term clinical and radiologic outcomes of cemented total hip arthroplasty in patients with ankylosing spondylitis. Materials and Methods A retrospective study of 12 patients (16 cases) diagnosed with ankylosing spondylitis undergoing total hip arthroplasty with cemented femoral stem from November 2002 to January 2006 with a minimum follow up of 10 years. Clinical outcomes were assessed using Harris Hip Scores and measures of pain and range of motion. Radiologic outcomes were assessed with serial plain X-ray. Fixation and stability of implant, enthesopathy of ischium and development of heterotopic ossification were also evaluated. Results Mean Harris Hip Scores significantly improved from pre-operative levels (58 points; range, 39–81 points) to post-operative (92 points; range, 68–100 points). Mean flexion contracture levels decreased from preoperative (13°) to post-operative (5°), and mean post-operative range of motion improved 106° compared to preoperative levels. No newly developed osteolysis lesions or implant loosening were observed in last follow up X-rays. One heterotopic ossification and one greater trochanter fracture were observed. Greater trochanter fracture was treated conservatively, and was resulted in bony union. No patients underwent revisions. Conclusion This study revealed positive long-term clinical and radiologic outcomes following total hip arthroplasty with cemented femoral stems in patients with ankylosing spondylitis patients.
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Affiliation(s)
- Soo Jae Yim
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Yong Bok Park
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Junyoung Kim
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sin Hyung Park
- Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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Connelly K, Segan J, Lu A, Saini M, Cicuttini FM, Chou L, Briggs AM, Sullivan K, Seneviwickrama M, Wluka AE. Patients' perceived health information needs in inflammatory arthritis: A systematic review. Semin Arthritis Rheum 2018; 48:900-910. [PMID: 30185378 DOI: 10.1016/j.semarthrit.2018.07.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/21/2018] [Accepted: 07/26/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To identify the breadth of the literature regarding patients' perceived health information needs related to inflammatory arthritis care. METHODS A systematic scoping review of MEDLINE, EMBASE, CINAHL and PsycINFO was performed to identify relevant articles (1990 -2016) examining patients' perceived needs relating to health information in inflammatory arthritis. Data and themes were identified and categorised and risk of bias assessed. RESULTS Twenty nine studies (11 quantitative, 14 qualitative and 4 mixed methods) from 4121 identified articles were relevant for inclusion. Most focussed on rheumatoid arthritis. Key findings included: (1) Reasons for seeking health information often focussed on gaining ownership over their condition and facilitating self-management. (2) Demographic differences in information needs were inconsistent, but women and younger patients generally reported more needs. (3) Desired information content was broad, and included targeted and practical information covering disease treatment and psychosocial wellbeing. (4) Preferred information delivery method was consultation with a Rheumatologist; however group sessions had advantages for psychosocial issues while written information provided useful supplementation. (5) Barriers to meeting health information needs were around timely access. CONCLUSIONS Patients with inflammatory arthritis have high information needs, desiring practical and individualised information. When developing strategies to meet patients' information needs, aligning patient expectations with delivery methods that are accessible, cost-effective and flexible may help to optimize patient outcomes.
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Affiliation(s)
- Kathryn Connelly
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Julian Segan
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Alicia Lu
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Meher Saini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Louisa Chou
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia; MOVE: Muscle, Bone & Joint Health, Victoria, Australia
| | - Kaye Sullivan
- Monash University Library, Monash University, Melbourne, Victoria, Australia
| | - Maheeka Seneviwickrama
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia.
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Using Self-Reported Patient Experiences to Understand Patient Burden: Learnings from Digital Patient Communities in Ankylosing Spondylitis. Adv Ther 2018; 35:424-437. [PMID: 29450863 PMCID: PMC5859700 DOI: 10.1007/s12325-018-0669-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Indexed: 12/17/2022]
Abstract
Introduction Online communities contain a wealth of information containing unsolicited patient experiences that may go beyond what is captured by guided surveys or patient-reported outcome (PRO) instruments used in clinical settings. This study described patient experiences reported online to better understand the day-to-day disease burden of ankylosing spondylitis (AS). Methods Unguided, English-language patient narratives reported between January 2010 and May 2016 were collected from 52 online sources (e.g., general/health social networking sites, patient–physician Q&A sites, AS forums). Using natural language processing combined with manual curation, patient-reported experiences within narratives were evaluated and categorized into social, physical, emotional, cognitive, and role activity (SPEC-R) concepts to assess functional impairment. The same SPEC-R categorization was applied to 5 AS-specific PRO instruments to evaluate their coverage of concepts extracted from patient narratives. Results A total of 34,780 narratives from 3449 patients with AS were included. Physical aspects of AS (e.g., pain and mobility) were most commonly reported by patients (86.7%), followed by emotional (32.5%), cognitive (23.6%), role activity (8.7%) and social (5.1%). Some frequently discussed subconcepts were effectively captured by ≥ 2 PRO instruments, such as pain (65.3%), asthenia (19.9%), musculoskeletal impairment (19.9%), depression (9.9%), and anger/frustration (5.4%); others [e.g., anxiety (19.1%), mental impairment (3.2%), impulsivity (2.9%)] were not addressed by any of the PRO instruments. Conclusion These findings highlight the importance of analyzing patient experiences beyond clinical trial settings and physician reports; continuous assessment of existing PRO instruments in collaboration with patients may increase their utility in real-world settings. Funding Novartis Pharmaceuticals Corporation. Electronic supplementary material The online version of this article (10.1007/s12325-018-0669-1) contains supplementary material, which is available to authorized users.
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Zhang M, Li XM, Wang GS, Tao JH, Chen Z, Ma Y, Li XP. The association between ankylosing spondylitis and the risk of any, hip, or vertebral fracture: A meta-analysis. Medicine (Baltimore) 2017; 96:e8458. [PMID: 29390254 PMCID: PMC5815666 DOI: 10.1097/md.0000000000008458] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Ankylosing spondylitis (AS) is an inflammatory rheumatic disease and strongly associated with an increased risk of fractures. A great proportion of patients with AS are suffering from sustaining fractures and the aim of this study is to evaluate and quantify the association between the site of the fracture and AS by performing a meta-analysis. METHODS A systematic literature search was performed on Medline database from 1966 to August 15, 2016 and Embase database from 1980 to August 15, 2016. Studies were evaluated by 2 independent reviewers and quantitative estimates regarding the association between ankylosing spondylitis and the risk of any, hip, or vertebral fracture were presented. After the heterogeneity of selected studies was assessed by using Cochran I statistics, the random effect model was used to combine effect size. Publication bias was measured by Egger and Begg's regression tests. RESULTS A total of 6 articles were involved in our study. The results of meta-analysis revealed that AS was strongly associated with the risk of vertebral fracture (odds ratio [OR] = 4.25, 95% confidence interval [CI] = 1.07-7.42) and was not significantly associated with the risk of any fracture (OR=2.00, 95%CI = 0.94-3.06) or hip fracture (OR=1.28, 95%CI =0.16-2.40). CONCLUSION In the present study, a general knowledge of the association between AS and the risk of 3 kinds of fractures were presented, which could improve the ways of prevention of fracture in the patients with AS.
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Garrido-Cumbrera M, Hillmann O, Mahapatra R, Trigos D, Zajc P, Weiss L, Bostynets G, Gossec L, Coates LC. Improving the Management of Psoriatic Arthritis and Axial Spondyloarthritis: Roundtable Discussions with Healthcare Professionals and Patients. Rheumatol Ther 2017; 4:219-231. [PMID: 28600789 PMCID: PMC5696278 DOI: 10.1007/s40744-017-0066-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Indexed: 12/17/2022] Open
Abstract
Psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA) are both chronic, inflammatory conditions that result in a substantial burden of disease and reduced quality of life for patients. Patient involvement in developing optimal disease management strategies, including defining appropriate goals, therapies, and treatment options, as well as in setting policy priorities and agendas, is key. A working group of patient organization representatives and rheumatologists explored what patients consider to be unmet needs, important treatment gaps, and future priorities in PsA and AxSpA management. Reducing pain and fatigue, and improving physical and social functioning and work productivity were identified as important treatment goals for patients. Although the major treatment target for both PsA and AxSpA is remission, with low/minimal disease activity an alternative target for patients with established or long-standing disease, the meaning of remission from the patient's perspective needs to be explored further as it may differ considerably from the physician's perspective. Key recommendations from the working group to tackle unmet needs included reducing time to diagnosis, increasing patient and physician disease awareness, focusing on patients' priorities for treatment goals, and improving patient-physician communication. By addressing these key action points moving forward, the hope is that outcomes will continue to improve for patients with PsA and AxSpA.
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Affiliation(s)
- Marco Garrido-Cumbrera
- CEADE (Coordinadora Española de Asociaciones de Pacientes de Espondiloartritis), Universidad de Sevilla, Seville, Spain
| | - Ottfrid Hillmann
- EUROPSO (European Umbrella Organisation for Psoriasis Movements), Almere, The Netherlands
| | - Raj Mahapatra
- ASIF (Ankylosing Spondylitis International Federation), London, UK
| | | | - Petra Zajc
- Slovenian Association of Rheumatic Patients, Ljubljana, Slovenia
| | - Luisa Weiss
- Schweizerische Polyarthritiker-Vereinigung, Zurich, Switzerland
| | | | - Laure Gossec
- Sorbonne Université, Paris 06 Univ, Paris, France
- Rheumatology Department, Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Laura C Coates
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
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22
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Alunno A, Studenic P, Nikiphorou E, Balážová P, van Nieuwkoop L, Ramiro S, Carubbi F, Richez C, Caeyers N, Gossec L, Kouloumas M. Person-focused care for young people with rheumatic and musculoskeletal diseases: young rheumatologists' and EULAR Young PARE perspectives. RMD Open 2017; 3:e000514. [PMID: 29018568 PMCID: PMC5623325 DOI: 10.1136/rmdopen-2017-000514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/03/2017] [Accepted: 08/20/2017] [Indexed: 12/15/2022] Open
Abstract
In recent years, the evolution of healthcare challenged the management of people with rheumatic and musculoskeletal diseases (RMDs). From disease-centred care to person-focused care, a holistic approach along with patient empowerment about their disease, improved the physician-patient relationship and allowed to achieve better outcomes with lower healthcare costs. Nevertheless, RMDs may occur from childhood to the old age and to date very few studies have addressed the needs and priorities of young people with RMDs. However, the image of RMDs is still associated with the elderly population. In this regard, the group of young people with arthritis and rheumatism in Europe (PARE) was recently developed within European League Against Rheumatism to represent the voice of the young affected and to carry out projects aiming for a better understanding of these specific aspects. This viewpoint discusses the needs and priorities of young people compared with adult people with RMDs, based on the available literature and on the results of the PARE Youth research project, aiming to identify the next steps of actions that need to be taken to improve the current situation.
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Affiliation(s)
- Alessia Alunno
- Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy
| | - Paul Studenic
- Division of Rheumatology, Department of Internal Medicine 3, Medical University Vienna, Vienna, Austria
| | - Elena Nikiphorou
- Department of Academic Rheumatology, King's College London, London, UK.,Department of Rheumatology, Whittington Hospital, London, UK
| | - Petra Balážová
- Patient, EULAR Young PARE, Zurich, Switzerland.,Slovak League Against Rheumatism, Piestany, Slovakia
| | | | - Sofia Ramiro
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Francesco Carubbi
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.,Department of Medicine, ASL1 Avezzano-Sulmona-L'Aquila, L'Aquila, Italy
| | - Christophe Richez
- Department of Rheumatology, FHU ACRONIM, Pellegrin Hospital and UMR CNRS 5164, Bordeaux University, Bordeaux, France
| | | | - Laure Gossec
- Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique (UMRS 1136), Paris, France.,Department of Rheumatology, Hôpital Pitié Salpêtrière, AP-HP, Paris, France
| | - Marios Kouloumas
- Patient, EULAR Young PARE, Zurich, Switzerland.,Cyprus Legue Against Rheumatism, Aglantzia, Cyprus
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Flórez García MT, Carmona L, Almodóvar R, Fernández de Las Peñas C, García Pérez F, Pérez Manzanero MÁ, García García JM, Soriano Segarra L, Jiménez Díaz JF, Mendoza Laiz N, de Miguel Mendieta E, Torre Alonso JC, Linares Ferrando LF, Collantes Estévez E, Sanz Sanz J, Zarco Montejo P. Recommendations for the prescription of physical exercise for patients with spondyloarthritis. ACTA ACUST UNITED AC 2017; 15:77-83. [PMID: 28807651 DOI: 10.1016/j.reuma.2017.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/12/2017] [Accepted: 06/25/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop expert-based recommendations on physical activity and exercise for patients with spondyloarthritis (SpA). METHODS Two discussion groups, one of physical therapists, rehabilitation physicians, and professionals of physical activity and sports, and another of rheumatologists interested in SpA, were held to discuss the results of a survey of rheumatologists on exercise and two focus groups with patients on barriers to exercise. Preliminary recommendations were drafted. These were submitted to the opinion of the experts in both groups according to a two round Delphi methodology. RESULTS Twenty one recommendations covering general aspects of exercise, adaptation to patient, how to deliver messages, pain management, and type of exercise and monitoring were issued. The level of agreement varied slightly between expert groups but it was high overall. Items with poor agreement were removed from the consensus. CONCLUSIONS We present recommendations on when and how to prescribe and monitor exercise in patients with SpA based on the opinion of experts in exercise and in SpA. We must now test whether these recommendations are useful for clinical practice and have an effect on patients with SpA seen by rheumatologists.
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Affiliation(s)
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética (InMusc), Madrid, España
| | - Raquel Almodóvar
- Servicio de Reumatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | | | - Fernando García Pérez
- Unidad de Rehabilitación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | | | - José Manuel García García
- Facultad de Ciencias de Actividad Física y Deporte, Universidad de Castilla La Mancha, Toledo, España
| | | | | | - Nuria Mendoza Laiz
- Facultad de Ciencias de Actividad Física y Deporte, Universidad de Castilla La Mancha, Toledo, España
| | | | | | | | | | - Jesús Sanz Sanz
- Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| | - Pedro Zarco Montejo
- Unidad de Rehabilitación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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Haglund E, Bremander A, Bergman S, Larsson I. Educational needs in patients with spondyloarthritis in Sweden - a mixed-methods study. BMC Musculoskelet Disord 2017; 18:335. [PMID: 28768510 PMCID: PMC5541660 DOI: 10.1186/s12891-017-1689-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/24/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is a demand for a flexible and individually tailored patient education to meet patients' specific needs and priorities, but this area has seldom been studied in patients with spondyloarthritis (SpA), a family of inflammatory rheumatic diseases. The aim of the present study was to identify needs and priorities in patient education in patients with SpA. A second aim was to investigate patients' experiences and preferences of receiving patient education. METHODS Data collection included a questionnaire survey with the Educational Needs Assessment Tool (ENAT) and interviews, using a mixed-methods design. Patients were identified through a specialist clinic register. Descriptive data are presented as mean with standard deviation, or frequencies. Chi-square test and independent-samples t-test were used for group comparisons. A manifest qualitative conventional content analysis was conducted to explore patients' experiences and needs in patient education, based on two focus groups (n = 6) and five individual interviews. RESULTS Almost half (43%) of the 183 SpA patients had educational needs, particularly regarding aspects of self-help, feelings, and the disease process. More educational needs were reported by women and in patients with higher disease activity, while duration of disease did not affect the needs. The qualitative analysis highlighted the importance of obtaining a guiding, reliable, and easily available patient education for management of SpA. Individual contacts with healthcare professionals were of importance, but newer media were also requested. CONCLUSION There are considerable educational needs in patients with SpA, and education concerning self-help, feelings, and the diseases process were raised as important issues. Healthcare professionals need to consider the importance of presenting varied formats of education based on the experiences and preferences of patients with SpA.
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Affiliation(s)
- Emma Haglund
- School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-30274 Halmstad, Sweden
| | - Ann Bremander
- School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-30274 Halmstad, Sweden
- Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden
| | - Stefan Bergman
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-30274 Halmstad, Sweden
- Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden
- Primary Health Care Unit, Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ingrid Larsson
- Spenshult Research and Development Center, Bäckagårdsvägen 47, SE-30274 Halmstad, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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25
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Almodóvar R, Gratacós J, Zarco P. Information needs of patients with spondyloarthritis about their disease. ACTA ACUST UNITED AC 2017; 14:367-371. [PMID: 28583786 DOI: 10.1016/j.reuma.2017.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 02/08/2017] [Accepted: 02/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE 1. To describe the information provided to, or inquired about, by patients with axial spondyloarthritis and psoriatic arthritis. 2. To analyze improvements. METHODS Analysis of the discourse of focus groups (with patients, some of them from patient associations, and rheumatologists). The discussion included the identification of elements that shape the reality being studied, describing the relationship among them and summarizing the results by: 1)thematic segmentation; 2)categorization according to situations, relationships, opinions, feelings or others; 3)coding of the various categories, and 4)interpretation of results. Representativeness was ensured by using a typological framework. RESULTS Rheumatologists are the main source of information. Patient associations have a fundamental role and are well-regarded. Internet is used with caution due to its limited reliability. Patients are interested in: disease characteristics and treatments, the course and prognosis, and social, administrative and other kinds of support. More information is needed (objective and constructive, avoiding a catastrophic tone); it should be provided progressively, adjusted to patients features and needs. There are areas for improvement including: the standardization and updating of contents (based on scientific evidence), the optimization of informative materials (written, electronic), and other resources such as nursing and primary care. CONCLUSIONS Rheumatologists are the main and most reliable source of information for patients with spondyloarthritis and psoriatic arthritis. Patient associations have an important role and are well-regarded. Changes in the content, format and sources of information are required.
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Affiliation(s)
- Raquel Almodóvar
- Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - Jordi Gratacós
- Hospital Universitario Parc Taulí, Sabadell, Barcelona, España
| | - Pedro Zarco
- Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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Xu J, Zeng M, Xie J, Wen T, Hu Y. Cementless total hip arthroplasty in patients with ankylosing spondylitis: A retrospective observational study. Medicine (Baltimore) 2017; 96:e5813. [PMID: 28121928 PMCID: PMC5287952 DOI: 10.1097/md.0000000000005813] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Controversies on the surgical protocols and efficacies of total hip arthroplasty (THA) in ankylosing spondylitis (AS) still exist. The aim of this study was to retrospectively analyze the perioperative managements and their outcomes related to performing THA on patients with AS.Data of 54 AS patients who underwent 81 THAs between 2008 and 2014 were retrospectively analyzed. Clinical and imaging data were collected preoperatively, postoperatively, and during the follow-up period for surgical efficacy.Using posterolateral approach, cementless prostheses were selected in all cases. Mean follow-up period was 3.6 years (range, 2-8 years). Inclinations and anteversions of acetabular cups were 36.3°±4.5° (range, 30°-50°) and 12.3°±4.9° (range, 0°-25°) respectively. Mean visual analog scale (VAS) score decreased from 6.7 ± 2.1 (range, 4-10) preoperatively to 1.5 ± 1.0 (range, 0-4) at final follow-up, and mean Harris hip score (HHS) improved from 31.2 ± 11.6 (range, 15-45) to 86.1 ± 4.3 (range, 80-95) (P < 0.05). Postoperative range of motion (ROM) in flexion was improved from 6.7°±13.5° (range, 0°-50°) preoperatively to 82.5°±6.4° (range, 70°-100°) at final follow-up, and ROM in extension was improved from 1.8°±5.7°(range, 0°-15°) to 15.4°±2.6° (range, 10°-20°) (P < 0.05). Heterotopic ossification (HO) was documented in 9 hips (11.1%). Signs of stable fibrous ingrowth and bone ingrowth were detected in 52 and 29 hips, respectively. Sciatic never injury was occurred in 3 cases, and treated conservatively. There were no signs of periprosthetic fractures, dislocation, or prosthesis loosening.Surgical efficacies of THA for AS patients with severe hip involvement are satisfactory.
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Affiliation(s)
- Jun Xu
- Department of Orthopedics, Seventh People's Hospital of Shenzhen, Shenzhen, Guangdong
| | - Min Zeng
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ting Wen
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yihe Hu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Truong SL, Saad NF, Robinson PC, Cowderoy G, Lim I, Schachna L, Stebbings S, Stuckey S, Taylor AL, Whittle SL, Zochling J, Bird P, Brown MA. Consensus statements on the imaging of axial spondyloarthritis in Australia and New Zealand. J Med Imaging Radiat Oncol 2016; 61:58-69. [DOI: 10.1111/1754-9485.12573] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 11/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Steven L Truong
- Department of Rheumatology; Auckland District Healthcare Board; Auckland New Zealand
- Translational Research Institute; Princess Alexandra Hospital; University of Queensland Diamantina Institute; Brisbane Queensland Australia
| | - Nivene F Saad
- Department of Radiology; Princess Alexandra Hospital; Woolloongabba Queensland Australia
- School of Medicine; University of Queensland; Herston Queensland Australia
| | - Philip C Robinson
- School of Medicine; University of Queensland; Herston Queensland Australia
| | - Greg Cowderoy
- Brisbane Private Imaging; Royal Brisbane and Womens’ Hospitals; Herston Queensland Australia
| | - Irwin Lim
- BJC Health; Sydney New South Wales Australia
| | | | - Simon Stebbings
- Department of Medicine; Dunedin School of Medicine; University of Otago; Dunedin New Zealand
- Department of Rheumatology; Dunedin Hospital; Dunedin New Zealand
| | - Stephen Stuckey
- Monash Imaging; Monash Health Departments of Medicine and Imaging; School of Clinical Studies at Monash Health; Monash University; Melbourne Victoria Australia
| | - Andrew L Taylor
- University of Western Australia; Perth Western Australia Australia
- Royal Perth Hospital; Perth Western Australia Australia
| | - Samuel L Whittle
- Rheumatology Unit; The Queen Elizabeth Hospital; Woodville South South Australia Australia
- The University of Adelaide; Adelaide South Australia Australia
| | - Jane Zochling
- Menzies Institute for Medical Research; University of Tasmania; Hobart Tasmania Australia
| | - Paul Bird
- University of New South Wales; Sydney New South Wales Australia
| | - Matthew A Brown
- Institute of Health and Biomedical Innovation; Translational Research Institute; Princess Alexandra Hospital; Queensland University of Technology; Brisbane Queensland Australia
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Saglam Y, Ozturk I, Cakmak MF, Ozdemir M, Yazicioglu O. Total hip arthroplasty in patients with ankylosing spondylitis: Midterm radiologic and functional results. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2016; 50:443-7. [PMID: 27492583 PMCID: PMC6197352 DOI: 10.1016/j.aott.2016.06.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 01/10/2016] [Accepted: 01/24/2016] [Indexed: 02/06/2023]
Abstract
Introduction The aim of this study was to evaluate the clinical and radiological outcomes of total hip arthroplasty (THA) in patients with Ankylosing Spondylitis (AS). Patients and methods One hundred five hips of 61 AS patients (mean age: 41.3 ± 10.2 years) who underwent THA between 1997 and 2012 were included into the study. Dorr's classification of proximal femoral geometry, acetabular protrusio, bone ankylosis, acetabular protrusion, Brooker classification of heterotopic ossification (HO), Gruen and Charnley classifications of implant loosening were used in radiographic assessments. Patients were called back to return for an additional long-term follow-up for functional assessment. Results Cementless total hip arthroplasty was used in 83 hips (79%) and cemented TKA was used in 22 hips (21%). The overall rate of aseptic loosening was 7.6% at a mean follow-up of 5.4 years. Femoral loosening was statistically similar in cemented and cementless femoral components (14% vs. 8%, p = 0.089). Acetabular component loosening was statistically higher in patients with any degree of HO (p = 0.04). Regardless of the type of femoral implant (cemented or cementless), femoral component loosening was higher in Dorr's type C patients (p = 0.005). The average pre-operative HSS was 46.6 ± 16.3, and it improved to 80.7 ± 18.7 at last follow-up (p < 0.01). Conclusion Revision incidence was similar in between ankylosed and non-ankylosed hips. While complication rates are high, significant functional improvement can be achieved after THA in patients with AS.
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Affiliation(s)
- Yavuz Saglam
- Biruni University Hospital, Orthopedics and Traumatology Department, Istanbul, Turkey.
| | - Irfan Ozturk
- Istanbul University, Istanbul Faculty of Medicine, Orthopedics and Traumatology Department, Istanbul, Turkey
| | - Mehmet Fevzi Cakmak
- Istanbul University, Istanbul Faculty of Medicine, Orthopedics and Traumatology Department, Istanbul, Turkey
| | - Mustafa Ozdemir
- Istanbul University, Istanbul Faculty of Medicine, Orthopedics and Traumatology Department, Istanbul, Turkey
| | - Onder Yazicioglu
- Istanbul University, Istanbul Faculty of Medicine, Orthopedics and Traumatology Department, Istanbul, Turkey
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da Rocha Lopes SM, Duarte JA, Mesquita CTTC. Cross-cultural adaptation and validation of the Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire". Rheumatol Int 2016; 36:515-9. [PMID: 26856726 DOI: 10.1007/s00296-016-3434-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/26/2016] [Indexed: 11/27/2022]
Abstract
Knowledge is an important factor in patients with ankylosing spondylitis regarding the adoption of appropriate behaviours and education. The aim of this study was to culturally adapt and validate "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" for the Portuguese population with ankylosing spondylitis. The Portuguese version of "The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire" was administered to a sample of 180 subjects, from which 63 individuals responded. The adaptation process involved translation, back-translation and submission to a committee of experts in the area, culminating with a Portuguese version of the instrument. Next, the scale reliability and validity were assessed. There was a statistically significant decrease from test to retest, although the intra-class correlation coefficient between test and retest was 0.76 (95 % CI 0.61-0.86), which was considered good. From 180 individuals, 63 (35.0 %) subjects were available for the present study. The proportion of individuals that correctly answered each item ranged from 19 to 92 %, corresponding to items 8 and 13, respectively. The mean number of correct answers was 8.5 [mean (SD) = 2.4] in 12 questions. The proposed Portuguese version of the ankylosing spondylitis knowledge scale showed good reliability, reproducibility and construct validity.
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Affiliation(s)
- Sofia Manuela da Rocha Lopes
- Escola Superior de Tecnologia da Saúde (School of Health Technology), Polytechnic Institute of Porto, Rua Valente Perfeito, 322, 4400-330, Vila Nova de Gaia, Portugal.
| | - José Alberto Duarte
- Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
| | - Cristina Teresa Torrão Carvalho Mesquita
- Escola Superior de Tecnologia da Saúde (School of Health Technology), Polytechnic Institute of Porto, Rua Valente Perfeito, 322, 4400-330, Vila Nova de Gaia, Portugal
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Jarernsiripornkul N, Phueanpinit P, Pongwecharak J, Krska J. Experiences of and attitudes towards receiving information about non-steroidal anti-inflammatory drugs: a cross-sectional survey of patients in Thailand. Expert Opin Drug Saf 2016; 15:417-26. [PMID: 26742855 DOI: 10.1517/14740338.2016.1139571] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To determine sources of information about NSAIDs used by out-patients, factors related to receipt of information and patient attitudes towards receiving safety information. RESEARCH DESIGN AND METHODS Cross-sectional survey, using self-completed questionnaires distributed directly to 500 outpatients prescribed any NSAIDs from an orthopaedic clinic in Thailand, over a 4-month period. RESULTS There were 548 patients approached and 474 completed questionnaires returned (94.8%). The most frequent aspects of medicines information that were provided related to administration (97.2%), mostly provided by pharmacists, and indication (85.8%), mostly provided by physicians. Information on identifying, monitoring and managing adverse effects was received by fewer than 50% of patients. Safety information was received significantly more frequently by younger patients (P<0.01), those using non-selective COX-2 inhibitors (P<0.001), intermittent NSAIDs (P<0.05) and fewer concomitant medicines (P<0.05). Only 14.1% patients used additional information sources. Attitudes towards receiving medicines safety information were positive. Most patients agreed they should know about ADRs (98.1%) and receive information leaflets with first prescription (96.8%). CONCLUSIONS Patients received medicines information mostly from healthcare professionals, but safety information was limited. Type of NSAIDs, regularity of NSAID use and age affected receipt of safety information about NSAIDs. Provision of more medicine information is needed, particularly written documents.
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Affiliation(s)
| | | | | | - Janet Krska
- c Medway School of Pharmacy , Universities of Greenwich and Kent , Kent , UK
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Ankylosing spondylitis self-help organisations - do members differ from non-members? Joint Bone Spine 2015; 83:295-300. [PMID: 26677993 DOI: 10.1016/j.jbspin.2015.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 06/21/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Joining a patient self-help organisation is recommended for patients with ankylosing spondylitis (AS). The objective was to compare AS patients who are members of a self-help organisation with non-members regarding disease specific and patient personality aspects, and make inferences on potential benefits of membership. METHODS A comprehensive questionnaire regarding demographics, smoking habits, acquisition of information about the disease, disease activity, functioning, patient satisfaction, treatment, sick leave, work disability and educational level was distributed to members of the German AS self-help organisation and to non-member AS patients. RESULTS In total, 1273 patients responded. Significant differences regarding age and disease duration led us to match members 2:1 to non-members. In the matched population (n=549), members had a higher level of education, felt more often well-informed about the disease, had less often physically demanding jobs, and smoked less than non-members. Members were more often treated with NSAIDs and less often with TNF-blockers suggesting more severe disease in non-members. While the level of disease activity was similar (BASDAI 4.1 vs. 4.2), members had a better functional status (BASFI 3.5 vs. 3.9) and significantly less days on sick leave during the last year (15.1 days vs. 31.2 days). Days on sick leave increased with increasing BASFI significantly more strikingly in non-members than in members. CONCLUSION AS patients who are members of an AS self-help organisation have a higher educational level and are much better informed about the disease. Inferences on disease outcome measures, however, are hampered by potential confounders.
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Madsen M, Jensen KV, Esbensen BA. Men's experiences of living with ankylosing spondylitis: a qualitative study. Musculoskeletal Care 2015; 13:31-41. [PMID: 25279843 DOI: 10.1002/msc.1082] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The majority of patients with ankylosing spondylitis (AS) are male, although potential gender differences have not been investigated in relation to disease management. Moreover, men's perceptions of experiencing AS have not been reported in the literature. AIMS This study sought to develop an understanding of how men experience AS and the challenges related to living with AS as a chronic disease. METHODS A purposive sample of 13 men diagnosed with AS, with a median age of 44 years (range 32-58) was recruited from a rheumatology outpatient clinic. The median duration of disease was 12 years (range 0.3-28 years), and the median time from the first symptom to final diagnosis was seven years (range 2-20 years). Semi-structured interviews were conducted using an interview guide, and the interviews were analysed using content analysis inspired by Graneheim qualitative methodology. RESULTS The analysis revealed four categories: (1) 'Approaching a diagnosis'; (2) 'Ill in a social context'; (3) 'Challenged as a man'; and (4) 'The importance of remaining physically well'. Based on these categories, the overall category of 'An invisible companion for life' emerged, which captures the experience of living with an invisible, life-long disease. CONCLUSIONS These findings demonstrate that AS impacts men's perceptions of themselves as men, relationships as a partner and father, social lives, and masculine identity. Physical activity was highlighted as an important part of being a man, and not being able to exercise challenged the men's masculine identity.
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Affiliation(s)
- Mette Madsen
- Nursing and Health Science Research Unit, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark; Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital, University of Copenhagen, Denmark
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Ye C, Liu R, Sun C, Lin J, Li H, Re H, Sun B, Sun Q, Yang L. Cementless bilateral synchronous total hip arthroplasty in ankylosing spondylitis with hip ankylosis. INTERNATIONAL ORTHOPAEDICS 2014; 38:2473-6. [PMID: 25030965 DOI: 10.1007/s00264-014-2461-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/04/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study was a retrospective analysis of early and mid-term clinical effects and perioperative management of cementless bilateral synchronous total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS) with bilateral hip ankylosis. METHODS Fifteen AS patients (30 hips) with bilateral hip ankylosis were managed with cementless bilateral synchronous THA. Surgical outcome was evaluated using the visual analogue scale (VAS), the range of motion and the Harris score. RESULTS The mean follow-up period was 29.3 months. At the last follow-up visit, the VAS score decreased from 7.53 ± 0.99 before the operation to 2.40 ± 0.91. The Harris score increased from 24.8 ± 7.42 before the operation to 83.8 ± 4.61. The total range of motion increased from 78.73 ± 14.53 before the operation to 209.73 ± 16.19 after the operation. After the operation, there was one case of early hip dislocation, one case of femoral nerve stretch injury and one case of superficial incision infection. There were no cases of deep venous thrombosis. X-ray examinations did not show prosthetic loosening or displacement. CONCLUSION AS patients with bilateral hip ankylosis can be treated with cementless bilateral synchronous THA, which could greatly improve hip joint function without significant complications. The clinical effects proved to be satisfactory.
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Affiliation(s)
- Chuan Ye
- Department of Orthopaedics, The Affiliated Hospital of Guiyang Medical College, Guiyang, 550004, China,
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Lubrano E, Astorri D, Taddeo M, Salzmann A, Cesarano E, Brunese L, Giganti M, Spadaro A. Rehabilitation and surgical management of ankylosing spondylitis. Musculoskelet Surg 2013; 97 Suppl 2:S191-S195. [PMID: 23949941 DOI: 10.1007/s12306-013-0285-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/11/2013] [Indexed: 06/02/2023]
Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory disease which, if untreated, may progress to severe damage of the spine with functional impairment, disability and poor quality of life. An increased mortality has been reported in AS patients compared to the general population. AS requires combined management (pharmacological and non-pharmacological) and advice by different health professionals. Even the pharmacological treatment in the last decade has dramatically changed the outcome, the severity of the disease might require a surgical approach for the hip involvement with total hip replacement, or the corrective spinal surgery. However, this surgery deserves some careful approaches since the complexity of the disease. Rehabilitation still represents a cornerstone of the global management of AS patients. The present review summarizes the state of art of surgical management of these two diseases.
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Affiliation(s)
- E Lubrano
- Academic Rheumatology Unit, Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
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Guan M, Wang J, Zhao L, Xiao J, Li Z, Shi Z. Management of hip involvement in ankylosing spondylitis. Clin Rheumatol 2013; 32:1115-20. [DOI: 10.1007/s10067-013-2278-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 04/19/2013] [Indexed: 01/26/2023]
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