Improving management of musculoskeletal disorders in primary care: the Joint Adventures Program.

Abstract:

:Musculoskeletal disorders represent a large and growing clinical challenge to primary care clinicians. Unfortunately, there appears to be a gap in current training and continuing education to meet this challenge. We used script concordance within a continuing medical education program entitled "Joint Adventures" to assist family physicians to acquire the knowledge, skills, and tools they need to improve their management of musculoskeletal disorders. Program workshops were coordinated through a national continuing education program of the College of Family Physicians of Canada. A group of 54 experts in musculoskeletal disorders including family physicians, rheumatologists, and orthopedists developed cases for six areas of management that were identified by family physicians during a needs survey delivered at a national scientific congress in primary care. Script concordance methodology was used in the Joint Adventures workshop to address knowledge gaps or lack of group consensus in the six areas including (1) diagnosis of osteoarthritis, (2) treatment and management of osteoarthritis, (3) treatment and management of rheumatoid arthritis, (4) diagnosis and treatment of back pain, (5) diagnosis and treatment of fibromyalgia and diagnosis, and (6) treatment of shoulder pain. Each workshop session included 5-30 family physicians, a specialist expert, and a family physician facilitator. Before each session, a group needs assessment was conducted to identify which one or two of the six cases would be used. Perceived knowledge and skill acquisition, self-assessed change in practice, and satisfaction with the program were measured at the conclusion of each session and again at 3 months post program. All programs were delivered from March 2003 to September 2005. Six hundred and fifty family physicians from across Canada completed the program. In general, participants reached concordance with each case. Measures of knowledge and skill acquisition and self-assessed change in practice were significantly improved with high rates of program satisfaction. The Joint Adventures program provided family physicians with knowledge and skills that changed their care of musculoskeletal disorders. This was achieved using consensus that was sensitive to local needs. Further use should be evaluated in other areas of medical practice as well.

journal_name

Clin Rheumatol

journal_title

Clinical rheumatology

authors

Petrella RJ,Davis P

doi

10.1007/s10067-006-0446-4

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

1061-6

issue

7

eissn

0770-3198

issn

1434-9949

journal_volume

26

pub_type

杂志文章
  • Antineutrophil cytoplasmic antibodies in juvenile chronic arthritis.

    abstract::We present the results of antineutrophil cytoplasmic antibody (ANCA) staining in patients with juvenile chronic arthritis (JCA). Thirty-one patients with an age range of 1-16 years were included in the study: 13, 15 and three patients, respectively, were classified having oligoarticular, polyarticular and systemic-ons...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s100670050106

    authors: Bakkaloglu A,Ozen S,Saatci U,Erguven S,Topaloglu R,Bassoy Y,Besbas N

    更新日期:1999-01-01 00:00:00

  • Potential and prognostic factor for belimumab-free remission in patients with systemic lupus erythematosus: a single-center retrospective analysis.

    abstract::Belimumab is an effective and safe treatment option for systemic lupus erythematosus (SLE). However, data on treatment cessation are lacking. Thus, we investigated belimumab-free remission in SLE patients. SLE patients receiving belimumab in our institute (May 1, 2013-May 31, 2019) were retrospectively identified usin...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-020-05052-0

    authors: Nakai T,Fukui S,Ikeda Y,Shimizu H,Tamaki H,Okada M

    更新日期:2020-12-01 00:00:00

  • Cardiovascular events prediction by left ventricular longitudinal strain and serum high-sensitivity troponin I in patients with axial spondyloarthritis.

    abstract:OBJECTIVE:Patients with axial spondyloarthritis (SpA) are subjected to elevated cardiovascular risks, but assessment of early myocardial damage and clinical risk stratification remained obscure. The aim of this study was to evaluate the prognostic value of speckle-tracking strain analysis and serum high-sensitivity tro...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-020-05112-5

    authors: Chen Y,Chan YH,Chung HY,Wu MZ,Yu YJ,Pi KL,Lau CS,Tse HF,Yiu KH

    更新日期:2020-11-01 00:00:00

  • Validation and implementation of a patient-reported experience measure for patients with rheumatoid arthritis and spondyloarthritis in the Netherlands.

    abstract:OBJECTIVES:To test the psychometric properties of the United Kingdom's Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) in patients with spondyloarthritis (SpA) and rheumatoid arthritis (RA) and to implement this questionnaire in daily practice in the Netherlands. METHO...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-020-05076-6

    authors: Beckers E,Webers C,Boonen A,Ten Klooster PM,Vonkeman HE,van Tubergen A

    更新日期:2020-10-01 00:00:00

  • HLA antigens in Yugoslav population with rheumatoid arthritis.

    abstract::The antigens of HLA-DR locus were determined in 127 patients with rheumatoid arthritis and in 175 healthy persons. The frequency of HLA-DR1 antigen was discovered in 45% of the patients and in 22.3% of the examinees from the control group (p less than 0.001). The relative risk is 2.84. 69% of the patients were seropos...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/BF02030241

    authors: Jajić Z,Jajić I,Jajić I,Kerhin-Brkljacic V

    更新日期:1990-03-01 00:00:00

  • Needs and preferences regarding health care delivery as perceived by patients with systemic sclerosis.

    abstract::This study aims to examine the needs and preferences regarding the delivery of health care services and information provision and their determinants in patients with systemic sclerosis (SSc). A questionnaire was sent to 77 SSc outpatients, comprising 27 items on health care needs within the domains physical, psycholog...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-010-1645-6

    authors: Schouffoer AA,Zirkzee EJ,Henquet SM,Caljouw MA,Steup-Beekman GM,van Laar JM,Vlieland TP

    更新日期:2011-06-01 00:00:00

  • Frequency and spectrum of outpatient musculoskeletal diagnoses at a pediatric hospital in Kenya.

    abstract::Chronic pediatric musculoskeletal (MSK) conditions are a major cause of morbidity. The burden of pediatric rheumatic diseases in East Africa is largely unknown. The purposes of this study were to estimate frequencies and assess the spectrum of MSK-related diagnoses using ICD-10 diagnostic codes among outpatients at a ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-018-4376-8

    authors: Scuccimarri R,Broten L,Migowa A,Ngwiri T,Wachira J,Bernatsky S,Hitchon C,Colmegna I

    更新日期:2019-04-01 00:00:00

  • Anxiety and depression in adult-onset Still's disease patients and associations with health-related quality of life.

    abstract:OBJECTIVE:Adult-onset Still's disease (AOSD) is an autoinflammatory disorder leading to multiorgan involvements. We sought to investigate mood status and the health-related quality of life (HRQoL) in these patients. METHODS:In this study, 82 AOSD patients and 82 age- and sex-matched healthy controls were included. Dem...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-020-05094-4

    authors: Chi H,Jin H,Wang Z,Feng T,Zeng T,Shi H,Wu X,Wan L,Teng J,Sun Y,Liu H,Cheng X,Ye J,Hu Q,Zhou Z,Gu J,Jia J,Liu T,Qiao X,Yang C,Su Y

    更新日期:2020-12-01 00:00:00

  • Chorea as a side effect of gabapentin (Neurontin) in a patient with complex regional pain syndrome Type 1.

    abstract::We report the case of a woman who developed chorea in her neck, trunk, and extremities soon after taking gabapentin as treatment for complex regional pain syndrome Type 1. The chorea lasted for a year and resolved completely within 2 weeks of discontinuing gabapentin. ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-007-0744-5

    authors: Zesiewicz TA,Shimberg WR,Hauser RA,Robinson W,Wilson MC,Sullivan KL

    更新日期:2008-03-01 00:00:00

  • Effect of thymidylate synthase (TYMS) gene polymorphisms with methotrexate treatment outcome in south Indian Tamil patients with rheumatoid arthritis.

    abstract::Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease causing joint damage and significant functional impairment. Methotrexate (MTX) remains the mainstay for the treatment of RA. MTX inhibits several enzymes of the folate and nucleotide pathways. Thymidylate synthase (TYMS) is an important enzyme in the d...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-017-3608-7

    authors: Muralidharan N,Misra DP,Jain VK,Negi VS

    更新日期:2017-06-01 00:00:00

  • Successful treatment of hypertrophic pachymeningitis in refractory Wegener's granulomatosis with rituximab.

    abstract::Central nervous involvement (CNS) is uncommon manifestation of Wegener's granulomatosis (WG). We are describing a patient with refractory WG with CNS involvement which responded to rituximab. This lady presented with nodular scleritis. Three months later, she developed headache, vision loss with complete opthalmoplegi...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-009-1291-z

    authors: Sharma A,Kumar S,Wanchu A,Lal V,Singh R,Gupta V,Singh S,Gupta A

    更新日期:2010-01-01 00:00:00

  • Decreased interleukin-20 level in patients with systemic sclerosis: are they related with angiogenesis?

    abstract::In this study, we aimed to evaluate the relation between angiogenesis indicators and T helper 17 cytokine group in patients with systemic sclerosis (SSc) which is a disease characterized by impaired angiogenesis and autoimmune response. In our study, patients with SSc are compared with patients with primary Raynaud's ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-013-2317-0

    authors: Aydoğdu E,Pamuk ÖN,Dönmez S,Pamuk GE

    更新日期:2013-11-01 00:00:00

  • Exposure to solvents in female patients with scleroderma.

    abstract::The role of exposure to solvents was investigated in female patients with connective tissue disease and Raynaud's phenomenon using a questionnaire. Sixteen out of the 63 patients with systemic sclerosis had been exposed to solvents. A borderline significance was demonstrated compared to matched female controls (P < 0....

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/pl00011216

    authors: Czirják L,Kumánovics G

    更新日期:2002-05-01 00:00:00

  • Polymyositis complicating donor lymphocyte infusion after stem cell transplantation for relapsed chronic myeloid leukemia: report of a case and review of literature.

    abstract::Polymyositis may occur along with other manifestations of chronic graft vs host disease after allogeneic bone marrow transplantation (BMT). Donor lymphocyte infusion (DLI) could produce durable remissions in relapsed patients with chronic myelogenous leukemia (CML) but it may contribute to the development of polymyosi...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-006-0346-7

    authors: Liu FC,Chen CH,Chao TY

    更新日期:2007-07-01 00:00:00

  • High-titer antichromatin antibody is associated with proliferative class IV of lupus nephritis.

    abstract::The antichromatin antibody (aCT) has been described as a useful marker for lupus nephropathy. The relevance of its nephritogenic potential may be appropriately evaluated in the context of renal histopathology. Therefore, the present study investigated the relationship of aCT with a particular histopathologic class of ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-008-0939-4

    authors: Carvalho JF,Viana VS,Borba EF,do Nascimento AP,Leon EP,Testagrossa LA,Barros RT,Bonfá E

    更新日期:2008-11-01 00:00:00

  • Noninvasive methods of bone-mass measurement.

    abstract::The most widely used noninvasive methods of bone mass measurement include: single photon absorptiometry (SPA), quantitative computed tomography (QCT), dual photon absorptiometry (DPA and DEXA). SPA is used to measure bone mineral content (BMC) of the distal radius. Its advantages are low cost and high precision in viv...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/BF02207232

    authors: Sabatier JP,Guaydier-Souquieres G

    更新日期:1989-06-01 00:00:00

  • Outcomes of dose reduction, withdrawal, and restart of tofacitinib in patients with rheumatoid arthritis: a prospective observational study.

    abstract:OBJECTIVE:This study was designed to compare outcomes of dose reduction, withdrawal, and continuation of tofacitinib in patients with rheumatoid arthritis (RA) and to examine effectiveness of rescue with an original treatment regimen for disease flare. METHODS:We prospectively enrolled 100 patients who had high or mod...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-019-04721-z

    authors: Mori S,Ueki Y

    更新日期:2019-12-01 00:00:00

  • Coexistence of ankylosing spondylitis and undifferentiated connective tissue disease.

    abstract::We report the case of a 45-year-old Caucasian woman suffering from ankylosing spondylitis and undifferentiated connective tissue disease in whom the prevailing clinical features were retinal vasculitis and inflammatory low back pain. HLA typing revealed the concomitant presence of B27 and DR2 antigens. We hypothesise ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF01451055

    authors: Galluzzo E,Taglione E,Bartolomei MP,Pasero G,Riente L

    更新日期:1998-01-01 00:00:00

  • Biologic disease-modifying anti-rheumatic drugs and patient-reported outcomes in axial SpA: a systematic review and a call for action.

    abstract::This paper is to assess the efficacy of different biologic DMARDs (bDMARDs) on several patient-reported outcomes (PROs) in randomized controlled trials (RCT) in axial spondyloarthritis (axSpA). A systematic literature review (SLR) was performed. MEDLINE (May 1, 2018) was used with the filters "published in the last 10...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/s10067-020-05209-x

    authors: Rodrigues-Manica S,Silva J,Cruz-Machado R,Coelho C,Duarte J,Vieira-Sousa E,Tavares-Costa J,Pimentel-Santos FM

    更新日期:2021-01-01 00:00:00

  • The association between TNF-alpha promoter polymorphisms and ankylosing spondylitis: a meta-analysis.

    abstract::The relationship of TNF-alpha promoter polymorphisms and ankylosing spondylitis (AS) has been reported with conflicting results. We perform this meta-analysis to collect all the relevant studies up to date to further clarify the association of TNF-alpha promoter polymorphisms with AS. A review was conducted of studies...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,meta分析

    doi:10.1007/s10067-010-1499-y

    authors: Li B,Wang P,Li H

    更新日期:2010-09-01 00:00:00

  • The role of the unfolded protein response in axial spondyloarthritis.

    abstract::Susceptibility to ankylosing spondylitis is highly genetic, with a heritability greater than 90 %. Presence of the HLA-B27 MHC class I allele remains the greatest genetic risk factor identified to date. Beyond its nominal role in antigen presentation, HLA-B27 displays interesting and possibly unique biochemical charac...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/s10067-015-3117-5

    authors: Smith JA

    更新日期:2016-06-01 00:00:00

  • Severity of symptoms persists for decades in fibromyalgia-a 26-year follow-up study.

    abstract::The aim of this study is to find out the outcome of 28 patients who got the diagnosis of primary fibromyalgia (pFM) 26 years ago. In 1986, 56 patients with widespread pain were examined and filled in a base questionnaire (BQ). Of them, 42 fulfilled the Yunus criteria for pFM. Twenty-six years later, addresses of 38 pa...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-017-3967-0

    authors: Isomeri R,Mikkelsson M,Partinen M,Kauppi MJ

    更新日期:2018-05-01 00:00:00

  • Rheumatoid arthritis in Burkina Faso: clinical and serological profiles.

    abstract::The objective of this work was to study the clinical and serological profiles of rheumatoid arthritis in Burkina Faso (West Africa). It is a cross-sectional study conducted from March 2006 to February 2009 in the Internal Medicine Department of the University Hospital Yalgado Ouedraogo. All patients seen in the rheuma...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-011-1831-1

    authors: Ouédraogo DD,Singbo J,Diallo O,Sawadogo SA,Tiéno H,Drabo YJ

    更新日期:2011-12-01 00:00:00

  • Syndrome of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) in siblings.

    abstract::PFAPA syndrome is characterized by episodes of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. PFAPA syndrome usually begins in children under 5 years old and normally has self-resolution. The etiology of PFAPA syndrome remains unknown. In this paper, we report the cases of two different famil...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-009-1222-z

    authors: Valenzuela PM,Majerson D,Tapia JL,Talesnik E

    更新日期:2009-10-01 00:00:00

  • Anti-cyclic citrullinated peptide antibodies in scleroderma patients.

    abstract::Anti-CCP (cyclic citrullinated peptide) is considered the most useful laboratory tool in the diagnosis of rheumatoid arthritis (RA). Some authors have also found this autoantibody in patients with scleroderma (SSc). The study aimed to investigate the prevalence of anti-CCP antibodies in SSc patients from Southern Braz...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-011-1930-z

    authors: Polimeni M,Feniman D,Skare TS,Nisihara RM

    更新日期:2012-05-01 00:00:00

  • Effect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, double-blind, placebo-controlled pilot study using MRI.

    abstract::This pilot study aimed to evaluate the correlation between clinical symptoms and cartilage volume through MRI in patients with knee osteoarthritis after 48 weeks of treatment with Structum®. Multicenter, double-blind, placebo-controlled, parallel-group study. Symptomatic knee osteoarthritis patients aged 50-75 years r...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s10067-012-2022-4

    authors: Railhac JJ,Zaim M,Saurel AS,Vial J,Fournie B

    更新日期:2012-09-01 00:00:00

  • Rheumatoid nodulosis: a puzzling variant of rheumatoid arthritis.

    abstract::Four patients with rheumatoid nodulosis are here described, together with a review of cases reported to date in the literature. This particular variant of rheumatoid arthritis (RA) is characterized by the presence of subcutaneous rheumatoid nodules, scanty or absent systemic manifestations and a clinically benign cour...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02207201

    authors: Goñi MA,Scheines EJ,Paira SO,Barceló HA,Maldonado Cocco JA

    更新日期:1992-09-01 00:00:00

  • Proteoglycan metabolism in isolated chondrocytes from human cartilage. Influence of niflumic acid.

    abstract::The effect of niflumic acid on hyaluronic acid and proteoglycan metabolism of human cartilage cells was investigated in vitro. Cartilage cells were obtained from five different donors. Niflumic acid levels used in the test systems ranged from 0 to 22 microgramsr/ml and were comparable to serum concentrations in humans...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02030238

    authors: Verbruggen G,Veys EM,Malfait AM,Schatteman L,Wieme N,Nimmegeers J,Gerin MG,Broddelez C

    更新日期:1990-03-01 00:00:00

  • Serum β2-microglobulin level is a useful indicator of disease activity and hemophagocytic syndrome complication in systemic lupus erythematosus and adult-onset Still's disease.

    abstract::This study demonstrates whether serum β2-microglobulin (β2-MG) level can be an indicator of the status of systemic lupus erythematosus (SLE) and adult-onset Still's disease (AOSD), and development of hemophagocytic syndrome (HPS) complication. Serum β2-MG level was compared between the active and inactive statuses of ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-013-2220-8

    authors: Wakabayashi K,Inokuma S,Matsubara E,Onishi K,Asashima H,Nakachi S,Hagiwara K

    更新日期:2013-07-01 00:00:00

  • Autonomic dysfunction in psoriatic arthritis.

    abstract::Autonomic nervous system (ANS) involvement has been studied in systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, Sjogren's syndrome, and ankylosing spondylitis but still has not been studied in psoriatic arthritis (PsA). The aim of this study was to investigate the prevalence and the nature of au...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-013-2239-x

    authors: Syngle A,Verma I,Garg N,Krishan P

    更新日期:2013-07-01 00:00:00