Sidney Kimmel Medical College
Office of CME
Jefferson Alumni Hall
1020 Locust Street
Philadelphia, PA 19107
Phone: (215) 955-6992
Toll Free: 1-888-JEFF-CME
Fax: (215) 923-3212
jeffersoncme@jefferson.edu


Since 2000

JMC Office of Continuing Medical Education
RAPID IV

 
 

Rheumatoid Arthritis: Primary Care Initiative for Improved Diagnosis and Outcomes

Welcome! This site has been created as a central location for professional education about the critical importance of the primary care provider (PCP) in the early diagnosis and management of patients with rheumatoid arthritis (RA). Because of the regularity of their interactions with patients, the PCP is the principal player in the early diagnosis of RA, and therefore may prevent severe joint damage and disability among their RA patients. By making an early, provisional diagnosis of RA and referring the patient to a rheumatologist for verification of the diagnosis and initiation of disease-modifying anti-rheumatic drugs (DMARDs), PCPs can maximize the probability of good outcomes. Aggressive monitoring and prevention of possible comorbid conditions, including infections and cardiovascular disease, is necessary. Close coordination of care between the PCP and the rheumatologist is therefore indispensable to ensure better patient outcomes.

Please visit us often for updates and links to information and educational activities.

Rheumatoid Arthritis: Primary Care Initiative for Improved Diagnosis and Outcomes

RAPID IV components currently include

  • CME Activity: Rheumatoid Arthritis: Primary Care Initiative for Improved Diagnosis and Outcomes at PriMed.com

  • CME Activity: Ask the Expert: Addressing questions on the management of patients with rheumatoid arthritis
    This activity is no longer certified for CME credit.

  • CME Monograph! Now Available: Primary Care Management of Rheumatoid Arthritis: Making the Diagnosis and Optimizing Outcomes
    This activity is no longer certified for CME credit.

  • The Clinician Educator plus iPhone application
    This activity is no longer certified for CME credit. However, you can still access the information.

  • Clinical Updates: Smartphone-based CME activities distributed by EPOCRATES/REALCME

Rheumatoid Arthritis: Primary Care Initiative for Improved Diagnosis and Outcomes at PriMed.com

Release date: October 24, 2011
Expiration date: October 24, 2012
Topics: Rheumatoid Arthritis, Rheumatology
Primary Audience: Primary Care

View the PriMed Webcast activity

Ask the Expert: Addressing questions on the management of patients with rheumatoid arthritis

In this Ask the Expert activity, Drs. Michael Weinblatt, Clifton Bingham, and Karen Costenbader respond to your clinical questions on topics relating to the management and care of patients with rheumatoid arthritis.

Release date: September 13, 2011
Expiration date: September 13, 2012
Estimated time to complete activity: 45 minutes

This activity is no longer certified for CME credit.

Co-sponsored by Curatio CME Institute and Jefferson Medical College of Thomas Jefferson University

Acknowledgements
Support for this activity has been provided through educational grants from Abbott Laboratories, Janssen Services, LLC, and Pfizer Inc.

CME Monograph: Primary Care Mangement of RA

Early diagnosis of RA is crucial to improved patient outcomes. Standard treatment regimens use disease-modifying antirheumatic drugs (DMARDs), which include methotrexate and biologics such as anti–tumor necrosis factor agents. This monograph focuses on the role of PCPs in the diagnosis and management of RA.

We are pleased to provide you with this CME monograph, Primary Care Management of Rheumatoid Arthritis: Making the Diagnosis and Optimizing Outcomes.

Primary care providers (PCPs) play a pivotal role in the management of rheumatoid arthritis (RA) , which is a progressive inflammatory disease of the joints that affects 1% of the US population.. Their active involvement through early diagnosis of RA and ongoing monitoring of RA patients is crucial to achieving successful outcomes. If treatment is not initiated in the early stages of the disease, many RA patients develop disabilities that compromise their ability to perform activities related to daily living.1 Fortunately, appropriate application of disease-modifying therapy, usually provided by rheumatologists, can reduce that potential for disability by more than 60%.1

RA is most effectively managed through an active collaboration between a PCP and a rheumatologist. This monograph will assist PCPs in making a provisional diagnosis of RA, and devotes particular attention to identifying situations when a rheumatologist should be consulted. It provides guidance regarding the referral of a patient to a rheumatologist, explains how to care for the patient while waiting for the rheumatologist to begin disease-modifying therapy, and describes some of the common comorbidities among RA patients.

Your commitment to patient care is crucial to improving the identification of RA in primary care and decreasing patients' long-term disability. We thank you for your continued dedication to furthering your clinical education and improving the care of your patients. We are confident that you will find the information in this monograph valuable to your practice, and we encourage you to share this information with other health care professionals.

Sincerely,

Michael E. Weinblatt, MD
John R. and Eileen K Riedman Professor of Medicine
Co-Director, Clinical Rheumatology
Division of Rheumatology, Immunology, and Allergy
Brigham and Women's Hospital
Boston, Massachusetts

Lauren G. Collins, MD
Assistant Professor of Family and Community Medicine
Jefferson Medical College of
Thomas Jefferson University
Philadelphia, Pennsylvania

References

  1. Bykerk VP, Keystone EC. RA in primary care: 20 clinical pearls. J Musculoskelet Med. 2004;21:133-146.

Access the Monograph CME information, post test and evaluation
This activity is no longer certified for CME credit.

Access a PDF of the Monograph (Physician | Patient Education)

The Clinician Educator plus iPhone Application

The Clinician Educator enduring material has been extremely popular with PCPs. It provides a concise summary of evidence-based practical guidance for PCPs, and patient education materials in a pocket sized, laminated fold-out card. Illustrations, charts, and graphs showing step-by-step diagnostic procedures, early treatment options, and monitoring concerns for the PCP are provided.

Access a PDF of the Clinician Educator (Physician | Patient Education)

Access the Clinician Educator CME information, post test and evaluation

Request a copy of the printed version of the Clinician Educator

The Clinician Educator iPhone application allows mobile access to additional content, including video clips of proper squeeze tests and audio clip case demonstrations. Download the Clinician Educator iPhone application.

Access the Clinician Educator iPhone application CME information, post test and evaluation

Request your CME Certificate for Epocrates/REALCME Clinical Updates

Importance of early diagnosis and treatment

To optimize the care of RA patients, it is important that PCPs recognize the early signs and symptoms of RA, and understand when to refer a patient to the rheumatologist. They then need to partner with the rheumatologist and other healthcare professionals (eg physical and occupational therapists, nurse practitioners) and the patient to ensure the best possible rheumatologic and global medical outcomes. PCPs need to be alert for general signs of increased disease activity, including fatigue, swollen and painful joints, and morning stiffness lasting more than 30 minutes, in order to alert the rheumatologist about possible changes in the patient's disease status. Aggressive monitoring and prevention of possible comorbid conditions, including infections and cardiovascular disease, is necessary. Close coordination of care between the PCP and the rheumatologist is therefore indispensable to ensure better patient outcomes.

How the RAPID program addresses these needs

RAPID IV is designed to increase the participants' knowledge, confidence in applying that knowledge, and practice when it comes to helping patients with RA. The interactive nature of these integrated CME activities not only conveys new knowledge, but introduces, reinforces, and recommends implementation of specific evidence-based RA diagnosis, treatment, and monitoring strategies and team treatment approaches. Competency will potentially be affected in the areas of medical knowledge, patient care, systems-based practice, patient-centered care, and working in interdisciplinary teams.

Resources

Selected References

Accreditation:
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME). Jefferson Medical College of Thomas Jefferson University is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Co-sponsored by Curatio CME Institute LLC

Support Acknowledgement:
Supported by educational grants from Abbott, Centocor Ortho Biotech Inc., and Pfizer.

RAPID IV Steering Committee and Disclosure Statements

Steering Committee

    Michael E. Weinblatt, MD–Co-Chair
    John R. and Eileen K. Riedman Professor of Medicine
    Harvard Medical School
    Co-Director, Clinical Rheumatology
    Division of Rheumatology, Immunology, and Allergy
    Brigham and Women's Hospital
    Boston, Massachusetts

    Lauren G. Collins, MD–Co-Chair
    Assistant Professor of Family and Community Medicine
    Jefferson Medical College of Thomas Jefferson University
    Philadelphia, Pennsylvania

    Clifton O. Bingham III, MD
    Associate Professor of Medicine
    Divisions of Rheumatology and Allergy and Clinical Rheumatology
    Director, Johns Hopkins Arthritis Center,
    Director, Rheumatology Clinics
    Johns Hopkins University
    Baltimore, Maryland

    Joyce P. Carlone, MN, RN, FNP-BC, CCRC
    Nurse Practitioner
    Division of Rheumatology
    Emory University
    Atlanta, Georgia

    Mary Suzanne Cleveland, JD (Patient/Patient Educator)
    Senior Analyst
    Kansas Health Institute
    Topeka, Kansas

    Jeanne G. Cole, EdD, FACME
    Director, Office of CME
    Jefferson Medical College of Thomas Jefferson University
    Philadelphia, Pennsylvania

    Karen H. Costenbader, MD, MPH
    Associate Physician
    Division of Rheumatology, Immunology and Allergy
    Brigham and Women's Hospital
    Assistant Professor of Medicine
    Harvard Medical School
    Boston, Massachusetts

    Paul P. Doghramji, MD, FAAFP
    Medical Director for Health Services at Ursinus College
    Family Physician, Collegeville Family Practice
    Collegeville, Pennsylvania

    Daniel Duch, PhD
    Medical Director
    Curatio CME Institute
    Exton, Pennsylvania

    David S. Kountz, MD, MBA, FACP
    Senior Vice President, Medical and Academic Affairs
    Jersey Shore University Medical Center
    Associate Professor of Medicine
    Robert Wood Johnson Medical School
    New Brunswick, New Jersey

Disclosure

Jefferson Medical College endorses the Standards of the Accreditation Council for Continuing Medical Education and the Guidelines for Commercial Support. Every effort has been made to encourage individuals to disclose any commercial relationships or personal benefit with commercial companies whose products are discussed in the educational presentation. Disclosure of a relationship is not intended to suggest or condone bias in any presentations, but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

The following individuals have declared no financial interests and/or affiliations:

    Mary Suzanne Cleveland, JD; Jeanne G. Cole, EdD; Lauren G. Collins, MD; Karen H. Costenbader, MD, MPH; Paul P. Doghramji, MD, FAAFP; Daniel Duch, PhD

The following individuals have declared financial interests and/or affiliations:

    Clifton O. Bingham III, MD
    Grant/Research Support: BMS, Genentech, UCB, Roche
    Consultant: Genentech, Roche, Centocor Ortho Biotech, Merck, UCB, Flexion, Celgene

    Joyce P. Carlone, MN, RN, FNP-BC, CCRC
    Consultant, Product/Speakers Bureau, Other: UCB

    David S. Kountz, MD, MBA, FACP
    Consultant: NiCox, Novartis

    Michael E. Weinblatt, MD
    Grant/Research Support: Abbott
    Consultant: Abbott, Centocor Ortho Biotech, Pfizer/Wyeth

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