1
|
Verbinnen I, Monte-Boquet E, Parow D, Lacombe F, Pothecary A, van Kuijk AWR, Harrington L, Müllerová E, Pinter A, Erstling U, Tomasini A, Helliwell PS. Elevating the Standard of Care for Patients with Psoriatic Arthritis: 'Calls to Action' from a Multistakeholder Pan-European Initiative. Rheumatol Ther 2024; 11:795-815. [PMID: 38662145 PMCID: PMC11111599 DOI: 10.1007/s40744-024-00664-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/11/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a complex, progressive, and often debilitating disease. Despite recent advances in treatment, numerous unmet needs in patient care persist. Rheumacensus is a multistakeholder, pan-European initiative designed to identify ways to elevate the standard of care (SoC) and treatment ambition for patients with PsA, using the perspectives of three key stakeholder groups: patients, healthcare professionals (HCPs) and payors. METHODS Rheumacensus followed three phases: an insights-gathering workshop to identify current unmet needs in PsA and an area of focus for the project, a modified Delphi process to gain consensus on improvements within the agreed area of focus, and a Consensus Council (CC) meeting which used consensus statements as inspiration to generate 'Calls to Action' (CTA)-practical measures which, if implemented, could elevate the SoC for patients with PsA. RESULTS The Rheumacensus CC consisted of four patient representatives, four HCPs and four payors. All 12 members completed all three Delphi e-consultations. The shared area of focus that informed the Delphi process was "patient empowerment through education on the disease and treatment options available, to enable patient involvement in management". Four key themes emerged from the Delphi process: patient empowerment, patient knowledge and sources of education, patient-HCP consultations, and optimal initial treatment. Statements within these themes informed 12 overarching CTA, which focus on the need for a multistakeholder approach to implementing a paradigm shift towards patient-centred care and improved outcomes for patients with PsA. CONCLUSION Rheumacensus has identified shortcomings in the current SoC for patients with PsA and provides a foundation for change through practical CTA. It is hoped that all stakeholders will now take practical steps towards implementing these CTA across Europe to elevate the SoC for patients with PsA.
Collapse
Affiliation(s)
- Iris Verbinnen
- Laboratory of Protein Phosphorylation and Proteomics, Department of Cellular and Molecular Medicine, Leuven Brain Institute, University of Leuven, Leuven, Belgium
| | - Emilio Monte-Boquet
- Pharmacy Department, Drug Clinical Area, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Detlev Parow
- Formerly Department of Medicines, Therapeutic Appliances and Remedies, DAK-Gesundheit, Hamburg, Germany
| | | | - Andrew Pothecary
- Department of Rheumatology, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Arno W R van Kuijk
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands
| | | | | | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - Ulrike Erstling
- Fachverband Rheumatologische Fachassistenz e.V., Bergisch Gladbach, Germany
| | - Andrea Tomasini
- National Association of People with Rheumatological and Rare Diseases, APMARR, Lecce, Italy
| | - Philip S Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| |
Collapse
|
2
|
Phoka A, van den Bemt BJF, Lubrano E, Singh I, Fernández-Carballido C, Parow D, Webb D, Lacombe F, Harrington L, Baraliakos X. Elevating the Standard of Care for Patients with Axial Spondyloarthritis: 'Calls to Action' from Rheumacensus, a Multistakeholder Pan-European Initiative. Rheumatol Ther 2024; 11:773-794. [PMID: 38662146 PMCID: PMC11111622 DOI: 10.1007/s40744-024-00663-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/11/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Several barriers to optimal care in axial spondyloarthritis (axSpA) exist, which is detrimental to patient outcomes. The Rheumacensus programme aimed to identify how the standard of care (SoC) and treatment ambition for patients with axSpA could be elevated, from the unique perspective of three key stakeholders from across Europe: patients, healthcare professionals (HCPs) and payors. METHODS Rheumacensus followed three phases: an insights-gathering workshop to identify current unmet needs in axSpA and an area of focus, a modified Delphi process to gain consensus on improvements within the agreed area of focus, and a Consensus Council (CC) meeting to generate 'Calls to Action' (CTA) to highlight the changes needed to elevate the SoC for patients with axSpA. RESULTS The Rheumacensus CC consisted of four patient representatives, four HCPs and four payors. All 12 members completed all three Delphi e-consultations. The shared area of focus that informed the Delphi process was patient empowerment through education on the disease and treatment options available, to enable patient involvement in management and ultimately increase treatment adherence. Four key themes emerged from the Delphi process: patient empowerment, patient knowledge, patient-HCP consultations and optimal initial treatment. These themes informed 11 overarching CTA, which demonstrate the need for a multistakeholder approach to implement a paradigm shift towards patient-centred care to elevate health outcomes in patients with axSpA. CONCLUSION Rheumacensus identified CTA to help bridge the disparities observed in axSpA care. It is now imperative for all stakeholders to take practical steps towards addressing these CTA to elevate the SoC and treatment ambition in patients with axSpA.
Collapse
Affiliation(s)
- Andri Phoka
- Axial Spondyloarthritis International Federation, Nicosia, Cyprus
| | - Bart J F van den Bemt
- Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands
- Department of Pharmacy, Radboud UMC, Nijmegen, The Netherlands
| | - Ennio Lubrano
- Academic Rheumatology Unit, Dipartimento di Medicina e Scienze Della Salute "Vincenzo Tiberio", Università Degli Studi del Molise, Campobasso, Italy
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven University, Leuven, Belgium
| | | | | | - Detlev Parow
- Formerly Department of Medicines, Therapeutic Appliances and Remedies, DAK-Gesundheit, Hamburg, Germany
| | - Dale Webb
- National Axial Spondyloarthritis Society, London, UK
| | | | | | | |
Collapse
|
3
|
Pijpers EJ, Bloemen B, Cup EHC, Groothuis JT, Oortwijn WJ, van Engelen BGM, van der Wilt GJ. The capability approach in rehabilitation: developing capability care. Disabil Rehabil 2024:1-13. [PMID: 38625146 DOI: 10.1080/09638288.2024.2342494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/09/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE To develop a multidisciplinary outpatient rehabilitation intervention for people with neuromuscular diseases (NMD) based on the capability approach: capability care for persons with NMD. MATERIALS AND METHODS The development process is described using a framework of actions for intervention development. It has been an iterative process consisting of a design phase based on theoretical insights and project group discussions, and a refine phase involving input from relevant stakeholders. RESULTS Multidisciplinary efforts have resulted in the development of capability care for rehabilitation of persons with NMD. It can focus both on facilitating and achieving functionings (beings and doings), as well as looking for alternative functionings that fulfil the same underlying value, thereby contributing to the persons' well-being. To facilitate a conversation on broader aspects that impact on well-being, persons with NMD receive a preparation letter and healthcare professionals are provided with guiding questions and practical tools to use. CONCLUSIONS We have shown that it is possible to develop a healthcare intervention based on the capability approach. We hope that rehabilitation professionals will be encouraged to use capability care and that other medical professionals will be inspired to develop capability care in their respective fields. REGISTRATION Registered at trialregister.nl NL8946.
Collapse
Affiliation(s)
- Eirlys J Pijpers
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Bloemen
- Donders Institute for Brain, Cognition and Behaviour, Department of IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Edith H C Cup
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan T Groothuis
- Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wija J Oortwijn
- Research Institute for Medical Innovation, Science Department IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Baziel G M van Engelen
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gert Jan van der Wilt
- Donders Institute for Brain, Cognition and Behaviour, Department of IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
4
|
Verdugo MÁ, Schalock RL, Gómez LE, Navas P. A Systematic Approach to Implementing, Evaluating, and Sustaining the Shared Citizenship Paradigm in the Disability Field. Behav Sci (Basel) 2023; 13:970. [PMID: 38131825 PMCID: PMC10740522 DOI: 10.3390/bs13120970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/01/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
The disability field continues to face challenges in transforming and implementing meaningful and effective changes in person-centered services and supports aligned with the principles of the Convention on the Rights of Persons with Disabilities. To guide this transformative process effectively, a paradigm must be operationalized through a systematic approach. This article outlines such a systematic approach, consisting of two components: (a) aligning the paradigm's foundational pillars to the elements of an explanatory/implementation model (the Quality of Life and Supports Model) to facilitate the paradigm's operationalization, acceptance, and application and (b) aligning implementation, evaluation, and sustainability strategies with ecological systems, implementation targets, and the paradigm's foundational pillars to drive change across systems. The synergy and alignment between these components underscore the importance of linking public policies with professional and organizational practices to promote social inclusion and enhance the quality of life for people with disabilities. We provide practical examples highlighting the collaborative potential of this synergy and emphasize the significance of evidence-based and person-centered practices in promoting equal rights and social inclusion for people with disabilities.
Collapse
Affiliation(s)
| | | | - Laura E. Gómez
- Department of Psychology, Universidad de Oviedo, 33003 Oviedo, Spain
| | - Patricia Navas
- INICO, Universidad de Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (P.N.)
| |
Collapse
|
5
|
Gemperli A, Essig S. Editorial: The role of primary and community care in rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1235049. [PMID: 37501702 PMCID: PMC10369340 DOI: 10.3389/fresc.2023.1235049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Armin Gemperli
- Health Services Research, Swiss Paraplegic Research, Nottwil, Switzerland
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| | - Stefan Essig
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| |
Collapse
|
6
|
van der Veen S, van der Leeden M, Geleijn E, Vossen P, Meskers CGM, Widdershoven GAM. Artificial intelligence to improve rehabilitation care for children with developmental conditions: Some ethical considerations. Dev Med Child Neurol 2023; 65:12-13. [PMID: 35856286 PMCID: PMC10084355 DOI: 10.1111/dmcn.15348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam
| | - Edwin Geleijn
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam
| | - Piek Vossen
- Computational Lexicology and Terminology Lab, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam Movement Sciences, Amsterdam
| | - Guy A M Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam
| |
Collapse
|
7
|
Beit Yosef A, Refaeli N, Jacobs JM, Shames J, Gilboa Y. Exploring the Multidimensional Participation of Adults Living in the Community in the Chronic Phase following Acquired Brain Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11408. [PMID: 36141678 PMCID: PMC9517339 DOI: 10.3390/ijerph191811408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/19/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
This exploratory study aimed to examine multiple aspects of the participation of adults in the chronic phase following acquired brain injury (ABI), considering different disability levels. Our study included 25 adults ≥6 months after ABI (predominantly stroke), living at home, without severe cognitive decline. Primary measures included the Canadian Occupational Performance Measure (subjective participation) and the Mayo-Portland Adaptability Inventory-4 Participation Index (objective participation). The results indicated subjective participation problems in all of the International Classification of Functioning, Disability and Health participation domains. In addition, objective participation was reported as most limited in the areas of leisure and recreational activities, residence, and employment. Both subjective and objective participation profiles varied according to the disability level except for the social and leisure areas, which were found to be similar across all subgroups. However, only partial compatibility was found between the subjective and objective participation aspects. To conclude, our findings indicated that chronic ABI survivors report a variety of subjective and objective participation concerns that varied according to their disability levels. Moreover, the incongruity between the participation aspects suggests that the level of limitation may not necessarily correspond to the importance of a particular participation area. This highlights the need for comprehensive assessments to determine unique individual participation profiles in order to facilitate client-centered interventions supporting the rehabilitation of community-dwelling ABI survivors.
Collapse
Affiliation(s)
- Aviva Beit Yosef
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
| | - Nirit Refaeli
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
| | - Jeremy M. Jacobs
- School of Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Department of Geriatrics and Geriatric Rehabilitation, Hadassah Medical Center, Jerusalem 9124001, Israel
| | - Jeffrey Shames
- Medical and Health Professions Division, Maccabi Health Services, Tel Aviv 6812509, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
| |
Collapse
|