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Khursheed T, Ovseiko P, Dyball S, Nakashima R, Gonzalez AMA, Babini A, Kalla AA, Hill C, Danda D, Dey D, Traboco L, Nikiphorou E, Harifi G, Badshah H, Hmamouchi I, Marie Von Feldt J, Farani JB, Andreoli L, Guimarães MP, Toro Gutiérrez CE, Sieiro Santos C, Duftner C, Alpizar Rodriguez D, Ziadé N, Palominos PE, Haq SA, Bautista-Molano W, Tanaka Y, Gossec L, Agarwal V, Wright GC, Coates L, Gupta L. Coalition for Health and Gender Equity (CHANGE)-a protocol for a global cross-sectional survey of health and gender equity in rheumatology. Rheumatol Adv Pract 2024; 8:rkae021. [PMID: 38560641 PMCID: PMC10980588 DOI: 10.1093/rap/rkae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/31/2023] [Indexed: 04/04/2024] Open
Abstract
Objectives The primary aim of the CHANGE survey is to determine the current state of gender equity within rheumatology, and secondarily, to review the physician perspective on bullying, harassment and equipoise of opportunities within rheumatology. Methods The CHANGE e-survey is a cross-sectional self-reported questionnaire adapted from EULAR's gender equity in academic rheumatology task force. The survey was launched in January 2023; it is available in six languages and distributed widely via rheumatology organizations and social media. Eligible participants include rheumatologist physicians and rheumatology health-care professionals. Survey responses will undergo descriptive analysis and inter-group comparison aiming to explore gender-based discrimination using logistic regression, with subgroup analyses for country/continent variations. Conclusion This e-survey represents a comprehensive global initiative led by an international consortium, aimed at exploring and investigating the gender-related disparities and obstacles encountered by rheumatologists and rheumatology health-care professionals across diverse communities and health-care environments. By pursuing this initiative, we aim to take the broader rheumatology community a step closer to understanding the underlying origins of inequities and their determinants. Such insights are pivotal in identifying viable interventions and strategies to foster gender equity within the field. Ultimately, our collective objective is to ensure equitable access to opportunities for every individual, irrespective of gender, thereby promoting inclusivity and fairness across the entire spectrum of professional practice and career development.
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Affiliation(s)
- Tayyeba Khursheed
- Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Pavel Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sarah Dyball
- Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ana Maria Arredondo Gonzalez
- Colombian Association of Rheumatology, Bogotá, Colombia
- Department of Rheumatology, Faculty of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
| | - Alejandra Babini
- Rheumatology Unit, Hospital Italiano de Cordoba, Cordoba, Argentina
| | - Asgar Ali Kalla
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Catherine Hill
- Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, SA, Australia
- Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Dzifa Dey
- Rheumatology Unit Department of Medicine and Therapeutics, Korle bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Lisa Traboco
- Department of Medicine, Section of Rheumatology, St Luke’s Medical Center-Global City, Taguig, Philippines
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King’s College London, London, UK
- Rheumatology Department, King’s College Hospital, London, UK
| | - Ghita Harifi
- Department of Rheumatology, Mediclinic Parkview Hospital, Dubai, United Arab Emirates
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Humeira Badshah
- Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates
| | - Ihsane Hmamouchi
- Clinical Epidemiology, Health Sciences College, International University of Rabat (UIR), Rabat, Morocco
- Department of Rheumatology, Provincial Hospital of Temara, Temara, Morocco
| | | | - Júlia Boechat Farani
- Division of Rheumatology, Hospital Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, Brazil
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Carlos Enrique Toro Gutiérrez
- General Director, Reference Center for Osteoporosis, Rheumatology and Dermatology, Pontifica Universidad Javeriana Cali, Cali, Colombia
| | | | - Christina Duftner
- Internal Medicine, Clinical Division of Internal Medicine II, Medizinische Universität Innsbruck, Innsbruck, Austria
| | | | - Nelly Ziadé
- Rheumatology Department, Hôtel-Dieu de France Hospital, Saint Joseph’s University, Beirut, Lebanon
| | | | | | - Wilson Bautista-Molano
- Rheumatology Division, University Hospital Fundación Santa Fé de Bogotá, Bogota, Colombia
- School of Medicine, Universidad El Bosque, Bogotá, Colombia
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Laure Gossec
- Sorbonne Université, INSERM, IPLESP, AP-HP, Pitié-Salpetrière Hospital, Paris, France
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Grace C Wright
- Association of Women in Rheumatology; United Rheumatology, New York, NY, USA
| | - Laura Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Latika Gupta
- Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Cruz LV, Farani JB, Costa JR, de Andrade Águas JV, Ruschel B, de Almeida Menegat F, Gasparin AA, Brenol CV, Kohem CL, Bessa A, Forestiero F, Thies F, Palominos PE. Patients with longstanding pPatients with longstanding psoriatic arthritis can achieve DAPSA remission or low disease activity and it correlates to better functional outcomes: results from a Latin-American real-life cohort. Adv Rheumatol 2024; 64:3. [PMID: 38167571 DOI: 10.1186/s42358-023-00338-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved. OBJECTIVES To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ - 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI. METHODS This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0. RESULTS Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16-0.6795% CI p = 0.002) and RR 0.96 (0.93-0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12-2.6095%CI p = 0.013)]. CONCLUSIONS In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI.
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Affiliation(s)
- Larissa Vargas Cruz
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | | | - Júlia Rabello Costa
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Bruna Ruschel
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Claiton Viegas Brenol
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Charles Lubianca Kohem
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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