Rheumatoid Arthritis Self-Management Toolkit for Physician Assistants
Rheumatoid Arthritis Toolkit for PAs
Keywords:
Rheumatoid Arthritis, Physician Assistants, Primary Health Care, Self-management Strategies, Chronic Disease ManagementAbstract
Background: Self-management is a key component of treatment for rheumatoid arthritis (RA), a systemic inflammatory autoimmune disease. Primary care physician assistants (PA) are uniquely situated to provide chronic disease management, equipping patients with the education and skills needed to self-manage RA. Purpose: To create a self-management toolkit for primary care PAs to use with patients diagnosed with RA. Methods: Characteristics of effective patient self-management interventions for individuals with RA were identified through a literature search. Ovid MEDLINE, EMBASE, and CINHAL databases were systematically searched and a total of 8 articles met inclusion criteria. Thematic analysis identified common themes of effective RA self-management interventions. Results: Four patient characteristics were identified to influence self-management of RA including patient medication management and education, healthy lifestyle, symptom management with non-pharmacological interventions, and emotion management. Two primary healthcare provider characteristics were identified to impact patient self-management of RA including smooth transition of care between healthcare providers and knowledgeability and confidence of primary healthcare providers. Implications: Based on the identified characteristics of effective RA self-management, a toolkit for primary care PAs was proposed.
References
Arthritis Alliance of Canada (AAC). (2011). The Impact of Arthritis in Canada: Today and Over the Next 30 Years. [PDF]. Available from: http://www.arthritisalliance.ca/images/PDF/eng/Initiatives/20111022_2200_impact_of_arthritis.pdf
Kordasiabi MC, Akhlaghi M, Baghianimoghadam MH, Morowatisharifabad MA, Askarishahi M, Enjezab B, Pajouhi, Z. Self Management Behaviors in Rheumatoid Arthritis Patients and Associated Factors in Tehran 2013. Glob J Health Sci. 2015;8(3):156-167.
Vallerand IA, Patten SB, Barnabe C. Depression and the risk of rheumatoid arthritis. Curr Opin Rheumatol. 2019;31(3):279-284.
Statistics Canada. Arthritis. [Internet]. Canada: 2008. Available from https://www150.statcan.gc.ca/n1/pub/82-229-x/2009001/status/art-eng.htm
Lefevre‐Colau M, Buchbinder R, Regnaux J, Roren A, Poiraudeau S, Boutron I. Self‐management education programmes for rheumatoid arthritis. Cochrane Database Syst Rev. 2014;10:1-15.
Health Council of Canada. Self-management support for Canadians with chronic health Conditions. [PDF]. Toronto; 2012. Available from https://www.selfmanagementbc.ca/uploads/HCC_SelfManagementReport_FA.pdf
Bodenheimer T, Wagner EH, Grumbach K. Improving Primary Care for Patients with Chronic Illness. JAMA. 2002;288(14):1775–1779.
Dhatt G, Simpson P, MacDonald, V. Self-management of osteoarthritis: A culturally-specific Chronic Care Model for South Asians. Int J Orthop Trauma Nurs. 2012; 16(3):121-127.
Arthritis Foundation. Rheumatoid Arthritis Treatment. [Internet]. Georgia, AL; n.d. Available from: https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/treatment.php
Pearson ML, Mattke S, Shaw R, Ridgely S, Wiseman, SH. Patient Self-Management Support Programs: An Evaluation. (2007). In: Final Contract Report (Prepared by RAND Health under Contract No. 282-00-0005). Rockville, MD: Agency for Healthcare Research and Quality. November 2007. Available from: AHRQ Publication No. 08-0011.
Østbye T, Yarnall KSH, Krause KM, Pollak KI, Gradison M, Michener JL. Is there time for management of patients with chronic diseases in primary care? Ann Fam Med. 2005;3(3):209-14.
Reid RJ, Wagner EH. Strengthening primary care with better transfer of information. CMAJ. 2008;179(10):987–988.
Santi N. Physician Assistants as Chronic Care Coordinators - An Interdisciplinary Patient Centered Approach to Managing Diabetes. UOJM. 2016;6(1):18-20.
Canadian Association of Physician Assistants (CAPA). History. [Internet]. Available from https://capa-acam.ca/about-pas/history/
Hooker RS, Everett CM. The contributions of physician assistants in primary care systems. Health Soc Care Community. 2012;20(1):20-31.
Hooker RS, Benitez JA, Coplan BH, Dehn R. Ambulatory Care and Chronic Disease by Physician Assistants and Nurse Practitioners. JACM. 2013;36(4):293-301.
Adams WL, Mcllvain HE, Lacy NL, Magsi H, Crabtree BF, Yenny SK, Sitorius, MA. Primary Care for Elderly People: Why Do Doctors Find It So Hard? Gerontologist. 2002;42(6):835-842.
National Commission on Certification of Physician Assistants. Just Released Data Registers Mobility Trends of Certified PAs. [Internet]. Johns Creek, GA; 2018. Available from: http://prodcmsstoragesa.blob.core.windows.net/uploads/files/PressRelease2017StatisticalReport.pdf
Canadian Health Institute for Health Information. Health Care in Canada, 2011: A focus on Seniors and Aging [PDF]. Available from: https://secure.cihi.ca/free_products/HCIC_2011_seniors_report_en.pdf
Rat AC, Henegariu V, Boissier MC. Do primary care physicians have a place in the management of rheumatoid arthritis? Joint Bone Spine. 2004;71(3):190-197.
Voshaar MJH, van de Laar MAFJ, va den Bemt BJF. Patient-centered care in established rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2015;29:643-663.
Bruce ML, Peck B. New Rheumatoid Arthritis Treatments. Nurse Pract. 2005;30(4):29-39.
Home D, Carr M. Rheumatoid arthritis: the role of early intervention and self-management. Br J Community Nurs. 2009;14(1): 432-436.
Lorig KR, Mazonson PD, Holdman HR. Evidence Suggesting That Health Education for Self-Management in Patients with Chronic Arthritis Has Sustained Health Benefits While Reducing Health Care Costs. Arthritis Rheum. 1993;36(4):439-446.
Lythgoe MP, Abraham S. Good practice in shared care for inflammatory arthritis. Br J Gen Pract. 2016;66: 275-277.
Margaretten M, Julian L, Katz P, Yelin E. Depression in patients with rheumatoid arthritis: description, causes and mechanisms. Int J Clin Rheumatol. 2011;6(6):617-623.
van Eijk-Hustings Y, Ammerlaan J, Voorneveld-Nieuwenhuis, Maat B, Veldhuizen C, Repping-Wuts H. Patients’ needs and expectations with regard to rheumatology nursing care: results of multicentre focus group interviews. Ann Rheum Dis. 2013;72:831-835.
Lineker SC, Bell MJ, Boyle J, Badley EM, Flakstad L, Fleming J, Lyddiatt A,
MacDonald J, McCarthy J, Zummer M. Implementing arthritis clinical practice guidelines in primary care. Med Teach., 2009;31(3):230-237.
Adams RJ. Improving health outcomes with better patient understanding and education. Risk Manag Healthc Policy. 2010;3:61-72.
Merriam SB. Andragogy and Self-Directed Learning: Pillars of Adult Learning Theory. New Directions for Adult and Continuing Education. 2001;(89):3-14.
Bayliss EA, Ellis JL, Steiner JF. Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. Ann Fam Med. 2007;5(5):395-402.
Edwards M, Wood F, Davies M, Edwards A. The development of health literacy in
patients with a long-term health condition: the health literacy pathway model. BMC Public Health. 2012;12:130-145.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Hannah Keith
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors published in the Journal of Canada's Physician Assistants (JCanPA) retain copyright of their articles, including all drafts and final published version. By agreeing to publish in JCanPA, authors grant the journal the right of first publication and distribution rights of the articles. Authors are free to submit their work to other publications in addition to JCanPA, provided they acknowledge its initial publication in JCanPA.
JCanPA is published online in the public domain. JCanPA holds no legal responsibility as to how these materials are used by the public. Please ensure all authors, co-authors, and investigators have read and agree to these terms.
