Improving Early Diagnosis & Treatment of Rheumatoid Arthritis

The Association of Reproductive Health Professionals (ARHP) is sponsoring Improving Early Diagnosis & Treatment of Rheumatoid Arthritis, an education program for health care providers.  This program is part of ARHP’s Women and Pain portfolio and builds on past success to educate women and their providers about chronic conditions such as fibromyalgia, osteoporosis, and hormone-related migraine.  The purpose of this program is to ensure that providers effectively identify and diagnose rheumatoid arthritis at an early stage in female patients, particularly those ages 30-55 and post-menopausal.  Additionally, the program provides strategies to employ a patient-centered approach to determining the most appropriate strategies for managing rheumatoid arthritis and common comorbidities.

For more information about the program, please contact Delysha D’Mellow Henry at dhenry@arhp.org or (202) 466-3825.

Background

Women are disproportionately affected by rheumatoid arthritis (RA), both in terms of the prevalence and severity of the disease.¹  Although RA can strike at any age, peak symptom onset typically occurs between ages 30-55-when many women are in the prime of their careers-which can lead to lost wages due to time off of work or disability-related unemployment.^2, 3  The debilitating nature of RA often takes a hefty toll on quality of life: depression is common among RA patients, which increases risks for additional comorbidities that can further compromise health outcomes.^4, 5

The prevalence of RA increases with age.  Experts estimate that RA currently affects up to one in 20 US women over age 65-and we can expect that number to rise as the population continues to age.^2, 6-7  This is particularly problematic since RA can lead to bone loss, osteoporosis, and disabling fractures-conditions that already contribute to significant morbidity and early mortality among postmenopausal women.⁸  Early diagnosis and initiation of effective treatments are critical for minimizing the widespread impacts of RA and reducing the likelihood of associated negative health outcomes.

Program Design and Educational Activities

• An accredited Power point slide set with talking points
• 1 live visiting faculty session at Reproductive Health 2010 and 1 virtual conference (archived)
• Integration of content into the Curricula Organizer for Reproductive Health Education (CORE), ARHP’s on-line, open-access collection of peer-reviewed, evidence-based teaching materials

Curriculum Learning Objectives

At the conclusion of the medical education sessions, participants will be able to:

• Recognize early RA symptoms to initiate a treatment plan or referral to a specialist.
• Given a patient with suspected early RA, evaluate patient history of common comorbidities, specifically cardiovascular disease, tobacco use, osteoporosis, and bone fractures.
• Employ a patient-centered approach to counseling,  assessing quality of life issues and thereby  improving adherence to treatment protocols for early RA..

Intended Audience and Accreditation

This program includes educational offerings for women’s health and primary care providers and educators (physicians, nurse practitioners, physician assistants, nurse midwives, and educators in ob/gyn, family medicine, internal medicine, and related fields).

The live session and virtual conference associated with this program will be accredited for continuing medical education and nursing contact hours.

Funding

This project is funded through educational grants from Pfizer and Duramed.

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1. Sokka T, Toloza S, Cutolo M, et al.  Women, men, and rheumatoid arthritis: Analyses of disease activity, disease characteristics, and treatments in the QUEST-RA Study.  Arthritis Res Ther.  2009;11(1):R7.
2. Harris ED, Schur PH.  Epidemiology, risk factors for, and possible causes of rheumatoid arthritis.  Up To Date.  2009 Sep 30.  Retrieved January 8, 2010, from www.uptodate.com.
3. Wolfe F, Allaire S, Michaud K.  The prevalence and incidence of work disability in rheumatoid arthritis, and the effect of anti-tumor necrosis factor on work disability.  J Rheumatol.  2007 Nov;34(11):2211-7.
4. Bruce TO.  Comorbid depression in rheumatoid arthritis: Pathophysiology and clinical implications.  Curr Psychiatry Rep.  2008 Jun; 10(3):258-64.
5. Joyce AT, Smith P, Khandker R, et al.  Hidden cost of rheumatoid arthritis (RA): Estimating cost of comorbid cardiovascular disease and depression among patients with RA.  J Rheumatol.  2009 Apr; 36(4):743-52.
6. US Census Bureau, Population Estimates Program.  T6-2008.  Sex By Age [39].  2008 Population Estimates.  Retrieved September 21, 2009 from http://factfinder.census.gov.
7. Hemlick CG, Felson DT, Lawrence RC, et al.  Estimates of the prevalence of arthritis and other rheumatic conditions in the United States.  Part I.  Arthritis Rheum.  2008 Jan; 58(1):15-25.
8. Michaud K, Wolfe F.  Comorbidites in rheumatoid arthritis.  Best Pract Res Clin Rheumatol.  2007 Oct; 21(5):885-906.