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Fast track clinics -the future of PMR care?
Over the past year we have implemented a fast track clinic for PMR at our institution in Dublin. Patients are referred predominantly from primary care, and we aim to see patients within a one to two week window. Without a doubt, patient outcomes are far superior with the instigation of the fast track clinic as part of our service.
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Blinkers and the Unseen Information Gap in PMR
In my earlier blog, PMR: glad or bad tidings? I mentioned our PMR Voices 2021 public engagement project. This project brought home to me as a physician that although our expertise is essential, one unfortunate side-effect is that our very expertise can give us “blinkers”. One result of our “blinkers” is that we may fail to see the extent of the information gap between us and our patients with newly-diagnosed PMR.
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Summary of recommendations for thrombotic microangiopathy (TMA), think of ADAMTS13, Ortel T, #ACR23 @RheumNow https://t.co/eSaocPSLUH
Dr. Antoni Chan ( View Tweet)
There are lots of reasons why First Nations people might have difficulties with rheumatology care (especially those in remote communities).
Population realities
Healthcare access
Medication access
All have a very real impact on the quality of care we deliver.
#ACR23 @RheumNow https://t.co/qDBsQRWjk9
David Liew drdavidliew ( View Tweet)
What did they do in Canada to improve the care for their patients of Indigenous background?
Practical but strategic approach to healthcare service improvement - that lead to real benefits.
#ACR23 @RheumNow https://t.co/VlGW3KBFCj
David Liew drdavidliew ( View Tweet)
Inequities in Medical Care Delivery:
👉>80% of people live in low/middle income places
👉2 billion people are unable to access meds and healthcare services
👉Availability, accessibility, affordability, acceptability are the 4 barriers
Dr. J Iyer #ACR23 @RheumNow #GlobalSummit https://t.co/u21NTAYBpY
TheDaoIndex KDAO2011 ( View Tweet)
2023 Medscaped Female Compensation Survey asked What percentage would again chose their specialty ?
Top 5 specialties rechosen:
Cardiology: 82% & Dermatology: 82%
Psychiatry: 81%
Allergy and immunology: 80%
Neurology: 79%
Rheumatology: 78% https://t.co/Zy4AJzb7dn. https://t.co/m9HjQ4T5aW
Dr. John Cush RheumNow ( View Tweet)
LANCET: Efgartigimod (neonatal Fc receptor mAb) shown effective in chronic #ITP. RCT, 205 pts with refractory ITP (Plt <30K for ~10.6 yrs) Rx w/ EFGR vs PBO. @24 wks EFGR incr Plt >50k in 22% vs. 6%). A larger RCT in progress https://t.co/uXyjYoXlyF https://t.co/jGroGNeD4W
Dr. John Cush RheumNow ( View Tweet)
Marijuana use is on the rise, including older adults. Data presented at 2023 AHA (cardiology) meeting suggests that marijuana user have higher risk of MI & CVA; & daily marijuana users were 34% more likely to develop heart failure (in hospitalized adults) https://t.co/EnEnf6pqdr https://t.co/GXSv30AFLr
Links:
Dr. John Cush RheumNow ( View Tweet)
New download available, titled "Dealing with Infections"
https://t.co/hsOuJoFokg https://t.co/G3MZ9BQo0X
Dr. John Cush RheumNow ( View Tweet)
Optimal Management of DQT
The treatment of DQT was examined by systematic review in JAMA, suggesting that local corticosteroid injection + a thumb spica immobilization was associated w/significant pain-relieving and functional benefits.
https://t.co/Qo5XGwCRsy https://t.co/58n74oFbfh
Dr. John Cush RheumNow ( View Tweet)
PMR Mythbusters: PMR Gets 100% Better Within 72 hours
https://t.co/S7PWlNoQez https://t.co/CN469rzGVl
Dr. John Cush RheumNow ( View Tweet)
Fast track clinics -the future of #PMR care?
As the month dedicated to PMR draws to a close, we begin to look to the future, and what the ideal management of PMR looks like.
https://t.co/F4oRPnKWhe https://t.co/1yoUNaQqW5
Dr. John Cush RheumNow ( View Tweet)
National Health Information Survey 2022 shows that 41.5% of US adults used the Internet to communicate with a doctor’s office; highest in metropolitan areas and decreasing in urban areas https://t.co/utU2YT7mt5 https://t.co/Y4U8ohy71s
Dr. John Cush RheumNow ( View Tweet)
Choosing steroid sparing therapies in #PMR
We have no evidence-based alternative treatment to glucocorticoids in PMR. Few disease-modifying anti-rheumatic drugs, such as methotrexate and leflunomide, are used in daily clinical practice in PMR.
https://t.co/zvfAwc7t1z https://t.co/pAJFHF6hOn
Dr. John Cush RheumNow ( View Tweet)
Blinkers and the Unseen Information Gap in #PMR
https://t.co/uZ9qCPmRw9 https://t.co/lrXRdVGNk2
Dr. John Cush RheumNow ( View Tweet)
Why should rheumatologists discuss exercise in #PMR?
https://t.co/DBnXetbu2K https://t.co/hfjugw661u
Dr. John Cush RheumNow ( View Tweet)
New download available--#PMR Survey Results
https://t.co/rfOQxFrO3I https://t.co/l8T7P3tdOb
Dr. John Cush RheumNow ( View Tweet)
#PMR Polymyalgia rheumatica is very common, yet there is little research on the Dx & Management of PMR by #PCPs! Mayo study prevalence 701 per 100,000 (women=870 and men =508 per 100,000 population). https://t.co/g6xIzsxjkr https://t.co/qQnouc5DPm
Links:
Dr. John Cush RheumNow ( View Tweet)
Universal Imaging for GCA in #PMR? Not So Fast
https://t.co/p581kXSzAb https://t.co/UIQjCxAzym
Dr. John Cush RheumNow ( View Tweet)
