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Management of Rheumatoid Arthritis in Primary Care: A Scoping Review

Author

Listed:
  • Francesco Inchingolo

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
    These authors contributed equally to this work.)

  • Angelo Michele Inchingolo

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
    These authors contributed equally to this work.)

  • Maria Celeste Fatone

    (PTA Trani-ASL BT, Viale Padre Pio, 76125 Trani, Italy)

  • Pasquale Avantario

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy)

  • Gaetano Del Vecchio

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy)

  • Carmela Pezzolla

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy)

  • Antonio Mancini

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy)

  • Francesco Galante

    (PTA Trani-ASL BT, Viale Padre Pio, 76125 Trani, Italy)

  • Andrea Palermo

    (College of Medicine and Dentistry, Birmingham B4 6BN, UK)

  • Alessio Danilo Inchingolo

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy)

  • Gianna Dipalma

    (Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy)

Abstract

Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the approach to RA in the PC setting. PubMed, Scopus, and Web of Science were searched using the MESH terms “rheumatoid arthritis” and “primary care” from 2013 to 2023. The search strategy followed the PRISMA-ScR guidelines. The 61 articles selected were analyzed qualitatively in a table and discussed in two sections, namely criticisms and strategies for the management of RA in PC. The main critical issues in the management of RA in PC are the following: difficulty and delay in diagnosis, in accessing rheumatological care, and in using DMARDs by GPs; ineffective communication between GPs and specialists; poor patient education; lack of cardiovascular prevention; and increase in healthcare costs. To overcome these criticisms, several management strategies have been identified, namely early diagnosis of RA, quick access to rheumatology care, effective communication between GPs and specialists, active patient involvement, screening for risk factors and comorbidities, clinical audit, interdisciplinary patient management, digital health, and cost analysis. PC appears to be the ideal healthcare setting to reduce the morbidity and mortality of chronic disease, including RA, if a widespread change in GPs’ approach to the disease and patients is mandatory.

Suggested Citation

  • Francesco Inchingolo & Angelo Michele Inchingolo & Maria Celeste Fatone & Pasquale Avantario & Gaetano Del Vecchio & Carmela Pezzolla & Antonio Mancini & Francesco Galante & Andrea Palermo & Alessio D, 2024. "Management of Rheumatoid Arthritis in Primary Care: A Scoping Review," IJERPH, MDPI, vol. 21(6), pages 1-35, May.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:6:p:662-:d:1399638
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    References listed on IDEAS

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    1. Shang-Ming Zhou & Fabiola Fernandez-Gutierrez & Jonathan Kennedy & Roxanne Cooksey & Mark Atkinson & Spiros Denaxas & Stefan Siebert & William G Dixon & Terence W O’Neill & Ernest Choy & Cathie Sudlow, 2016. "Defining Disease Phenotypes in Primary Care Electronic Health Records by a Machine Learning Approach: A Case Study in Identifying Rheumatoid Arthritis," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-14, May.
    2. Chiranjeev Sanyal & Paul Stolee & Don Juzwishin & Don Husereau, 2018. "Economic evaluations of eHealth technologies: A systematic review," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-11, June.
    3. Anna-Sophia Beese & Dunja Nicca & Rebecca Jaks & Natascha Stuermer & Saskia Maria De Gani, 2022. "How Do Primary Care Organizations Rate Their Level of Organizational Health Literacy? Results of a Swiss Pilot-Study," IJERPH, MDPI, vol. 19(23), pages 1-20, December.
    4. Daniel Erku & Resham Khatri & Aklilu Endalamaw & Eskinder Wolka & Frehiwot Nigatu & Anteneh Zewdie & Yibeltal Assefa, 2023. "Digital Health Interventions to Improve Access to and Quality of Primary Health Care Services: A Scoping Review," IJERPH, MDPI, vol. 20(19), pages 1-15, September.
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