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ACR News 3 – October 23, 2018

newspaper in mail slotACE is reporting from this week’s American College of Rheumatology/Association of Rheumatology Health Professionals 2018 Annual Meeting. Here are some presentations that are important for arthritis patients.

The future of arthritis care and the next generation of arthritis specialists 

The Arthritis Alliance of Canada has looked carefully at how patients with arthritis receive timely diagnosis and treatment. Central to ensuring timely care is making sure there are adequate numbers of rheumatologists for making an early diagnosis and starting appropriate treatment. In 2015, the Canadian Rheumatology Association conducted a national workforce survey of rheumatologists across Canada. The survey found there is a current shortage of rheumatologists across the country that may worsen over the next 10 years because a third of the workforce reported plans to retire in the near future. This will occur at the same time as an expected increase in the number of arthritis patients within the next generation.

At this week’s ACR meeting, Dr. Ian B. McInnes, PhD, FRCP, FRSE, FMed Sci, Professor of Rheumatology, University of Glasgow and Dr. Barbara Slusher, MSW, PA-C, DFAAPA, Assistant Professor of Instruction in the Department of Physician Assistant Studies at the University of Texas, looked at the future of rheumatology during a keynote address: “2030: A Rheumatology Odyssey.”

“When we think about what has happened in the last couple of decades, it is nothing short of remarkable,” said Dr. McInnes. “But there are challenges on the horizon. One of the challenges is that what we’re doing costs money.”

However, Dr. Slusher noted, cost savings happen when integrating nurse practitioners, physician assistants and other health care professionals on a patient’s healthcare team: “We do know that the data does show for the past 50 years that we do provide a cost savings, and that we do make a difference and improve patient outcomes, safety, patient education, and shared decision making,” she said.

Slusher described an integrated practice unit at the University of Texas that encompasses physician assistants, chiropractors, dieticians, social workers and others.

Dr. McInnes noted the next generation of practice will see a shift in focus to preventing disease rather than treating disease. He said practicing medicine at the molecular level, rather than the organ level, will guide decisions about prevention and treatment: “We’d like to make a molecular diagnosis to get the right medicine at the right time at the safest dose, when it has the best chance of preventing damage, addressing the totality of the disease and not just the identifiable measures,” he said. “What an extraordinary opportunity precision medicine will offer us.”

For example, using genetic profiles, physicians can predict 90 percent of the patients who will not respond to methotrexate, allowing them to try the next possible solution without wasting three to six months on a medication that doesn’t work.

“That’s the real joy of molecular medicine in 2030,” said Dr. McInnes. He added: “Molecular medicine will give us back the power to make the right decision for people. We will finally know the person the disease has rather than the disease that has the person.”

Mobile tech benefits for patients and healthcare professionals

At an ACR session, “Get Smart: Mobile and Wearable Technology in Rheumatology,” provided updates to attendees on the latest in wearable technology and other digital health advances. Dr. William Dixon, MRCP, PhD, Professor Digital Epidemiology and Director of the Arthritis Research UK entre for Epidemiology, discussed the benefits of using mobile and wearable technology in clinical practice, as well as the challenges of integrating patient data into clinical settings. Dr. Dixon was the chief investigator of the Remote Monitoring of Rheumatoid Arthritis Study, which involved the development, testing, and evaluation of a smartphone app to remotely monitor symptoms in patients.

“Currently, RA patients are asked about changes in their conditions at clinic appointments that can be up to several months apart, which means patients may struggle to accurately remember the details of these changes,” Dr. Dixon said. “The app allowed patients to record symptoms on a daily basis and log the impact of their RA between clinic appointments.”

The data were sent directly to and integrated with the patients’ electronic health records, he said, while anonymized data was also sent to a research database. Patients and their physicians were able to use the app data to discuss how their RA had changed since the previous appointment.

“Both patients and healthcare professionals found the app usable and thought it collected the right data and provided insight into changes in RA symptoms through time,” Dr. Dixon said. “New ways of gathering passive and self-reported data regularly from the patient, and integrating this with their rheumatology electronic health record, has the potential to transform management, leading to improved health, well being and patient satisfaction.”

Did you know that ACE has developed its own apps for patients and healthcare professionals?

ArthritisID is the most comprehensive free arthritis app for consumers, featuring the most current, evidence-based arthritis information to help detect, treat and manage arthritis. ArthritisID provides patients with unlimited free access to all features – all materials are available in English and French.

ArthritisID includes:

  • Screen for arthritis – ArthritisID’s interactive arthritis screening tool and questionnaire helps patients determine indications of a type of arthritis
  • Understand arthritis better – ArthritisID features treatment strategies and medication information for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout and juvenile idiopathic arthritis
  • ArthritisID contains the most current, evidence-based information on the prevention of arthritis, as well as information about exercise, diet and nutrition
  • ArthritisID lets patients save past arthritis screenings, or those of friends and family
  • ArthritisID lets patients send important arthritis information and resources by e-mail from the app directly to those who need it
  • The app connects patients to the North American arthritis community through social media networks and access more resources

ArthritisID also has a free companion app for healthcare professionals, calledArthritisID PRO, which has additional features.

Arthritis Consumer Experts is reporting from the ACR meeting and encourages you, our members and subscribers, to send us your science questions. Follow #AskACE on Facebook at Arthritis Consumer Experts and Twitter at @ACEJointHealth to keep up with the conversation.

Click here to send your questions.