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Duarte C, Spilker RLF, Paiva C, Ferreira RJO, da Silva JAP, Pinto AM. MITIG.RA: study protocol of a tailored psychological intervention for managing fatigue in rheumatoid arthritis randomized controlled trial. Trials 2023; 24:651. [PMID: 37803467 PMCID: PMC10559483 DOI: 10.1186/s13063-023-07692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Despite remarkable medical advances in the treatment of rheumatoid arthritis (RA), a subset of patients fails to achieve complete clinical remission, as the Patient Global Assessment (PGA) of disease activity remains above 1, even after the inflammatory process is brought under control. This so-called state of 'PGA-near-remission' negatively impacts individuals' functioning and potentiates inadequate care. Fatigue is a distressing and disabling symptom frequently reported by patients in PGA-near-remission, and its management remains challenging. While classic cognitive-behavioural interventions show some benefits in managing fatigue, there is potential for improvement. Recently, contextual-cognitive behavioural therapies (CCBT), like mindfulness, acceptance, and compassion-based interventions, have shown promising results in fatigue-associated disorders and their determinants. This study primarily aims to examine the efficacy of the Compassion and Mindfulness Intervention for RA (MITIG.RA), a novel intervention combining different components of CCBT, compared to treatment-as-usual (TAU) in the management of RA-associated fatigue. Secondary aims involve exploring whether MITIG.RA produces changes in the perceived impact of disease, satisfaction with disease status, levels of depression, and emotion-regulation skills. METHODS This is a single center, two-arm parallel randomized controlled trial. Patients will be screened for eligibility and willingness to participate and will be assessed and randomized to the experimental (MITIG.RA + TAU) or control condition (TAU) using computer randomization. MITIG.RA will be delivered by a certified psychologist and comprises eight sessions of 2 h, followed by two booster sessions. Outcomes will be assessed through validated self-report measures, including fatigue (primary outcome), perceived impact of disease, depressive symptoms, mindfulness, self-compassion, safety, and satisfaction (secondary outcomes). Assessment will take place at baseline, post-intervention, before the first and second booster sessions (weeks 12 and 20, respectively), and at 32 and 44 weeks after the interventions' beginning. DISCUSSION We expect MITIG.RA to be effective in reducing levels of RA-associated fatigue. Secondarily, we hypothesize that the experimental group will show improvements in the overall perceived impact of disease, emotional distress, and emotion regulation skills. Our findings will contribute to determine the benefits of combining CCBT approaches for managing fatigue and associated distress in RA. TRIAL REGISTRATION ClinicalTrials.gov NCT05389189. Registered on May 25, 2022.
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Affiliation(s)
- Cátia Duarte
- Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal.
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.
| | | | - Cláudia Paiva
- Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
| | - Ricardo J O Ferreira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisbon, Portugal
| | - José A Pereira da Silva
- Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
| | - Ana M Pinto
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Assessing life-space mobility : A systematic review of questionnaires and their psychometric properties. Z Gerontol Geriatr 2022; 55:660-666. [PMID: 35244765 PMCID: PMC9726808 DOI: 10.1007/s00391-022-02035-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/27/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Life-space mobility (LSM), as the extent of mobility within one's environment, is a key for successful aging and has become a relevant concept in gerontology and geriatric research. Adequate assessment instruments are needed to identify older persons with LSM restrictions, and to initiate, adapt or evaluate intervention strategies. OBJECTIVE To systematically identify, describe and analyze the psychometric properties of LSM questionnaires, with a special focus on their availability in the German language. METHODS A systematic literature search was conducted in PubMed, PsycINFO, Cochrane Library, CINAHL, and Web of Science. Studies that examined at least one psychometric property of LSM questionnaires published up to August 2021 were included and evaluated based on the consensus-based standards for the selection of health measurement instruments (COSMIN) guidelines. RESULTS This study included 37 validation studies describing 13 different LSM questionnaires. Methodological quality and comprehensiveness of validations were heterogeneous. Based on comprehensive and high-quality results, four LSM questionnaires stood out: the University of Alabama at Birmingham life-space assessment (UAB-LSA), life-space assessment in persons with cognitive impairment (LSA-CI), interview-based and proxy-based versions of the life-space assessment in institutionalized settings (LSA-IS), all of them available in the German language. CONCLUSION This systematic review provides a concise overview of available LSM questionnaires and their psychometric properties to facilitate the selection for use in clinical practice and research. The UAB-LSA and LSA-CI for community settings and the interview-based or proxy-based LSA-IS for institutional settings were found to be the most appropriate LSM questionnaires.
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Melikoglu MA, Ataman S, Bodur H, Cay HF, Capkin E, Akgul O, Cevik R, Gogus F, Kamanli A, Yurdakul FG, Gurer G, Yagci I, Rezvani A, Duruoz MT, Sunar I. Clinical performance of rheumatoid arthritis impact of disease score: a real-life evidence from the multicenter nationwide registry BioStaR. Rheumatol Int 2021; 41:1971-1978. [PMID: 34559275 DOI: 10.1007/s00296-021-04992-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
The rheumatoid arthritis impact of disease (RAID) score was developed as a patient-derived composite response index for the evaluation of the disease impact on cases with rheumatoid arthritis (RA). The aim of this study was to evaluate the psychometric properties and performance of RAID score in the real-life settings. Cases with RA from our multi-center, nationwide registry called Biologic and targeted Synthetic antirheumatic drugs Registry RA (BioStaR RA) were included in this cross-sectional observational study. Demographic data, disease duration, pain, patient's global assessment (PGA) and physician's global assessment (PhyGA) were recorded. DAS28-ESR, DAS28-CRP, the simplified disease activity index (SDAI) and the clinical disease activity index (CDAI) were assessed as disease activity evaluations. The health assessment questionnaire-disability index (HAQ-DI) and RAID were completed by all the participants. The construct validity was tested by the analysis of correlations between RAID score and scores of PGA, disease activity indexes and HAQ-DI. We also evaluated the discriminatory ability of RAID to distinguish patients with different levels of disease activity and disability and the cut-off values were calculated by ROC analysis. 585 cases with RA were included in this investigation. The RAID score was significantly positively correlated with PGA, all disease activity indexes and HAQ-DI (p < 0.001). The discriminatory ability of RAID score in different disease activity and disability groups was also demonstrated (p < 0.001). To estimate DAS28-ESR (remission/low + moderate + high), RAID score cut-off points were 2.88 (sensitivity 73%, specificity 62%), 3.23 (sensitivity 75%, specificity 60%) and 3.79 (sensitivity 74%, specificity 58%), respectively. Our study indicated that RAID was a reliable tool in daily clinical practice by presenting its correlations with disease activity and disability assessments and by showing its discriminatory ability in these parameters in the real-life experiences.
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Affiliation(s)
- Meltem Alkan Melikoglu
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Ataturk University School of Medicine, Erzurum, Turkey.
| | - Sebnem Ataman
- Division of Rheumatology, Department of Physical Medicine and Rehabilitaton, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Hatice Bodur
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Hasan Fatih Cay
- Department of Rheumatology, Antalya Education and Research Hospital, Saglik Bilimleri University, Antalya, Turkey
| | - Erhan Capkin
- Department of Physical Medicine and Rehabilitation, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Ozgur Akgul
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | - Remzi Cevik
- Department of Physical Medicine and Rehabilitation, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Feride Gogus
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Gazi University School of Medicine, Ankara, Turkey
| | - Ayhan Kamanli
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Sakarya University School of Medicine, Sakarya, Turkey
| | - Fatma Gul Yurdakul
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Gulcan Gurer
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ilker Yagci
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey
| | - Aylin Rezvani
- Department of Physical Medicine and Rehabilitation, İstanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Mehmet Tuncay Duruoz
- Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, Istanbul, Turkey
| | - Ismihan Sunar
- Rheumatology Clinic, Aydin State Hospital, Aydın, Turkey
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Ferreira RJO, Welsing PMJ, Jacobs JWG, Gossec L, Ndosi M, Machado PM, van der Heijde D, Da Silva JAP. Revisiting the use of remission criteria for rheumatoid arthritis by excluding patient global assessment: an individual meta-analysis of 5792 patients. Ann Rheum Dis 2021; 80:293-303. [PMID: 33023964 DOI: 10.1136/annrheumdis-2020-217171] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/29/2020] [Accepted: 09/03/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To determine the impact of excluding patient global assessment (PGA) from the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission criteria, on prediction of radiographic and functional outcome of rheumatoid arthritis (RA). METHODS Meta-analyses using individual patient data from randomised controlled trials testing the efficacy of biological agents on radiographic and functional outcomes at ≥2 years. Remission states were defined by 4 variants of the ACR/EULAR Boolean definition: (i) tender and swollen 28-joint counts (TJC28/SJC28), C reactive protein (CRP, mg/dL) and PGA (0-10=worst) all ≤1 (4V-remission); (ii) the same, except PGA >1 (4V-near-remission); (iii) 3V-remission (i and ii combined; similar to 4V, but without PGA); (iv) non-remission (TJC28 >1 and/or SJC28 >1 and/or CRP >1). The most stringent class achieved at 6 or 12 months was considered. Good radiographic (GRO) and functional outcome (GFO) were defined as no worsening (ie, change in modified total Sharp score (ΔmTSS) ≤0.5 units and ≤0.0 Health Assessment Questionnaire-Disability Index points, respectively, during the second year). The pooled probabilities of GRO and GFO for the different definitions of remission were estimated and compared. RESULTS Individual patient data (n=5792) from 11 trials were analysed. 4V-remission was achieved by 23% of patients and 4V-near-remission by 19%. The probability of GRO in the 4V-near-remission group was numerically, but non-significantly, lower than that in the 4V-remission (78 vs 81%) and significantly higher than that for non-remission (72%; difference=6%, 95% CI 2% to 10%). Applying 3V-remission could have prevented therapy escalation in 19% of all participants, at the cost of an additional 6.1%, 4.0% and 0.7% of patients having ΔmTSS >0.0, >0.5 and >5 units over 2 years, respectively. The probability of GFO (assessed in 8 trials) in 4V-near-remission (67%, 95% CI 63% to 71%) was significantly lower than in 4V-remission (78%, 74% to 81%) and similar to non-remission (69%, 66% to 72%). CONCLUSION 4V-near-remission and 3V-remission have similar validity as the original 4V-remission definition in predicting GRO, despite expected worse prediction of GFO, while potentially reducing the risk of overtreatment. This supports further exploration of 3V-remission as the target for immunosuppressive therapy complemented by patient-oriented targets.
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Affiliation(s)
- Ricardo J O Ferreira
- Rheumatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal
| | - Paco M J Welsing
- Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, The Netherlands
| | | | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Université, Paris, France
- Rheumatology, Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Mwidimi Ndosi
- Faculty of Health and Applied Sciences, University of the West of England Bristol, Bristol, UK
| | - Pedro M Machado
- Centre for Rheumatology & Department of Neuromuscular Diseases, University College London, London, UK
- Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK
- Rheumatology, Northwick Park Hospital, London North west UniversityHealthcare NHS Trust, London, UK
| | | | - Jose A P Da Silva
- Rheumatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- Clínica Universitária de Reumatologia, and i-CBR Coimbra Institute for Clinical and Biological Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Ferreira RJO, de Wit M, Henriques M, Pinto AF, Duarte C, Mateus E, Mendes G, da Silva JAP, Ndosi M. 'It can't be zero!' Difficulties in completing patient global assessment in rheumatoid arthritis: a mixed methods study. Rheumatology (Oxford) 2020; 59:1137-1147. [PMID: 31600398 DOI: 10.1093/rheumatology/kez467] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/20/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Patient global assessment (PGA) is purported to add the patient's perspective in the composite measures of RA. However, PGA is not standardized and it is not known whether patients' interpretation of the measure is consistent with its intended purpose. This study aimed to explore difficulties experienced by patients with RA in completing PGA, and to assess the impact of a structured explanation in improving its validity and reliability. METHODS This was a mixed methods study, using interviews, focus groups and PGA data. During interviews, patients (convenience sample, n = 33) completed three often-used PGA formulations. Then a nurse provided structured explanation about what PGA is and why it is used. After further discussion, patients completed one PGA version again. Interviews were recorded, transcribed and analysed using inductive thematic analysis. We compared PGA scores pre- and post-explanation (Wilcoxon signed-ranks) and the proportion of patients achieving RA remission with PGA ⩽1 (McNemar's tests). RESULTS Three themes emerged: understanding the meaning of PGA, the purpose of PGA and measurement difficulties. The difficulties caused systematic errors in PGA completion such as marking higher when feeling well, marking near the centre or away from zero. The structured explanation was helpful. Following the explanation, the median PGA score decreased from 3.0 to 2.1 cm, and the proportion of non-remission solely due to PGA >1 from 52% to 41%; none of these changes was statistically significant. CONCLUSION Many patients have difficulties in completing PGA. Standardization of PGA and a structured explanation may improve its clarity, validity and reliability.
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Affiliation(s)
- Ricardo J O Ferreira
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Health Sciences Research Unit: Nursing (UICiSA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Maarten de Wit
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands.,Patient Research Partner, EULAR standing committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
| | | | - Ana F Pinto
- Faculty of Medicine, University of Coimbra, Coimbra
| | - Cátia Duarte
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine -University of Coimbra, Coimbra
| | - Elsa Mateus
- Patient Research Partner, EULAR standing committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland.,Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon
| | - Gabriel Mendes
- Department of National Team, Portuguese Cycling Federation, Lisbon
| | - José A P da Silva
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine -University of Coimbra, Coimbra.,Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
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Santos EJF, Duarte C, da Silva JAP, Ferreira RJO. The impact of fatigue in rheumatoid arthritis and the challenges of its assessment. Rheumatology (Oxford) 2020; 58:v3-v9. [PMID: 31435662 PMCID: PMC6827262 DOI: 10.1093/rheumatology/kez351] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/16/2019] [Indexed: 01/22/2023] Open
Abstract
Fatigue is one of the most important symptoms for patients with RA, and imposes a great burden on patients’ lives, being associated with significantly reduced health-related quality of life. Although being recognized by the rheumatology community as a major gap in the current management of the disease, fatigue has not been easy to measure and conceptualize. Part of the problem seems to reside in the multidimensional causality of this phenomenon, which may warrant dedicated measures and interventions. Although there are several instruments available to measure it, no consensus has yet been reached to recommend a ‘gold-standard’. This review aims at synthesizing the role of fatigue in the global impact of RA; describing validated instruments and their psychometric properties as measures of fatigue among patients with RA; and finally proposing a clinically meaningful, valid and feasible process to measure fatigue in clinical practice.
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Affiliation(s)
- Eduardo J F Santos
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto.,Health Sciences Research Unit: Nursing, Nursing School of Coimbra, University of Coimbra, Coimbra, Portugal
| | - Catia Duarte
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Coimbra Institute for Clinical and Biomedical Research (iCBR) - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - José A P da Silva
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Coimbra Institute for Clinical and Biomedical Research (iCBR) - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ricardo J O Ferreira
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Health Sciences Research Unit: Nursing, Nursing School of Coimbra, University of Coimbra, Coimbra, Portugal
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Ferreira RJO, Santos EJF, de Wit M, Marques A, Barbieri-Figueiredo MDC, Marques A, Ventura F, da Silva JAP, Ndosi M. Shared decision-making in people with chronic disease: Integrating the biological, social and lived experiences is a key responsibility of nurses. Musculoskeletal Care 2020; 18:84-91. [PMID: 31837252 DOI: 10.1002/msc.1443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Ricardo J O Ferreira
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Eduardo J F Santos
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal
| | - Maarten de Wit
- Patient research partner, EULAR Standing Committee of People with Arthritis/Rheumatism in Europe, Zurich, Switzerland
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Andréa Marques
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
| | - Maria do Céu Barbieri-Figueiredo
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal
- Nursing School of Porto, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - António Marques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- AGI médica I, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Filipa Ventura
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - José A P da Silva
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
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Ferreira RJO, Ndosi M, de Wit M, Santos EJF, Duarte C, Jacobs JWG, Machado PM, van der Heijde D, Gossec L, da Silva JAP. Dual target strategy: a proposal to mitigate the risk of overtreatment and enhance patient satisfaction in rheumatoid arthritis. Ann Rheum Dis 2019; 78:e109. [PMID: 30127056 DOI: 10.1136/annrheumdis-2018-214199] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 07/31/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Ricardo J O Ferreira
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICiSA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, University Hospitals Bristol, Bristol, UK
| | - Maarten de Wit
- Patient Research Partner, EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
- Department of Medical Humanities, Amsterdam University Medical Center, Amsterdam Public Health (APH), Amsterdam, The Netherlands
| | - Eduardo José Ferreira Santos
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICiSA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Escola Superior de Enfermagem do Porto, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Cátia Duarte
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Johannes W G Jacobs
- Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands
| | - Pedro M Machado
- Centre for Rheumatology and MRC Centre for Neuromuscular Diseases, University College London, London, UK
- Rheumatology Department, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK
| | | | - Laure Gossec
- Sorbonne Universités, UPMC University Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France
- Rheumatology Department, AP-HP, Pitié-Salpetrière Hospital, Paris, France
| | - Jose A P da Silva
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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