Rheumatology Advances in Practice最新文献

{"title":"Behçet's disease-associated myositis presenting as exercise-induced leg pain.","authors":"Richard Porter, Pippa Watson, Yee Chiu, Eleftherios Agorogiannis","doi":"10.1093/rap/rkae122","DOIUrl":"10.1093/rap/rkae122","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae122"},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy of rheumatology patients in three clinics in Australia and its association with sociodemographic and clinical characteristics.","authors":"Ted Yi-Eng Tsai, Alexander Podgorski, Anmar Al-Heilfi, Geraldine Hassett, Alexandra Gorelik, Rachelle Buchbinder, Kathryn Gibson","doi":"10.1093/rap/rkae113","DOIUrl":"10.1093/rap/rkae113","url":null,"abstract":"<p><strong>Objectives: </strong>To describe and compare health literacy (HL) using contrasting instruments of Rapid Estimate of Adult Literacy in Medicine (REALM) and the Health Literacy Questionnaire (HLQ) in patients attending three Australian rheumatology clinics and their associations with sociodemographic and clinical characteristics.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of rheumatology patients at Liverpool (Sydney) and Canberra public hospital clinics and a private Liverpool clinic using the REALM test and HLQ sociodemographic and clinical questionnaires. One-way analysis of variance and multivariate ordinal and binary logistic regressions were used to examine the association between HL and sociodemographic and clinical factors.</p><p><strong>Results: </strong>A total of 278 people participated (111 Liverpool public, 112 private, 55 Canberra public clinic). Compared with Canberra, Liverpool patients were older, non-native English speakers, had less than a tertiary education and were more likely to have comorbidities. A total of 40% of Liverpool public, 29% of private and 13% of Canberra patients had suboptimal REALM HL scores (<i>P</i> < 0.05). Lower REALM scores were associated with male gender, <10 years of education, being born outside Australia/New Zealand and English as a secondary language, but was not associated with clinical characteristics. All nine HLQ domain scores did not differ across sites despite intergroup comparisons as stratified by REALM bands. Completing 10 years of schooling was associated with better scores in three HLQ scales: 'Navigating the healthcare system' (<i>P</i> = 0.009), 'Ability to find information' (<i>P</i> < 0.001) and 'Reading and understanding information' (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Patient HL as measured by the REALM differed across sites, explained by differences in gender distribution, country of birth, English as the primary language and years of education. HL as measured by the HLQ did not differ across sites and was more informative for understanding differing patient HL needs.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae113"},"PeriodicalIF":2.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VEXAS syndrome as a mimicker of ANCA-associated vasculitis.","authors":"Franco Murillo-Chavez, Brendan Antiochos","doi":"10.1093/rap/rkae116","DOIUrl":"https://doi.org/10.1093/rap/rkae116","url":null,"abstract":"<p><strong>Objectives: </strong>Differentiating VEXAS syndrome from cases of canonical forms of primary vasculitis remains a significant clinical challenge, particularly for ANCA-associated vasculitis (AAV). We reviewed the clinical features of VEXAS as an AAV mimicker, while adding three new cases to the existing literature.</p><p><strong>Methods: </strong>We identified three cases of VEXAS with an AAV phenotype in our institution. We performed a comprehensive literature search of available similar cases and summarized and compared the findings. Inclusion criterion was a positive <i>UBA1</i> mutation analysis.</p><p><strong>Results: </strong>Patient 1 was referred for evaluation of eosinophilic granulomatosis with polyangiitis (GPA), but had no active respiratory symptoms, despite CT imaging showing widespread ground-glass opacities. Patient 2 had no history of sinus disease, despite being referred under the diagnostic construct of limited GPA. Patient 3 developed a novel inflammatory syndrome suspected to represent GPA. Six other cases were identified upon literature review. In all the cases, the most common findings were pulmonary infiltrates (67%), skin involvement (55%) and ocular manifestations (44%). Additionally, 44% of cases had renal involvement, with half of them displaying kidney lesions resembling the typical AAV pattern.</p><p><strong>Conclusion: </strong>VEXAS can mimic different phenotypes of AAV and should be considered in atypical AAV presentations, especially when refractory to multiple treatments. Further studies are needed to explore the immunologic basis for an AAV phenotype within the spectrum of VEXAS.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae116"},"PeriodicalIF":2.1,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing rheumatology with natural language processing: insights and prospects from a systematic review.","authors":"Mahmud Omar, Mohammad E Naffaa, Benjamin S Glicksberg, Hagar Reuveni, Girish N Nadkarni, Eyal Klang","doi":"10.1093/rap/rkae120","DOIUrl":"https://doi.org/10.1093/rap/rkae120","url":null,"abstract":"<p><strong>Objectives: </strong>Natural language processing (NLP) and large language models (LLMs) have emerged as powerful tools in healthcare, offering advanced methods for analysing unstructured clinical texts. This systematic review aims to evaluate the current applications of NLP and LLMs in rheumatology, focusing on their potential to improve disease detection, diagnosis and patient management.</p><p><strong>Methods: </strong>We screened seven databases. We included original research articles that evaluated the performance of NLP models in rheumatology. Data extraction and risk of bias assessment were performed independently by two reviewers, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to evaluate the risk of bias.</p><p><strong>Results: </strong>Of 1491 articles initially identified, 35 studies met the inclusion criteria. These studies utilized various data types, including electronic medical records and clinical notes, and employed models like Bidirectional Encoder Representations from Transformers and Generative Pre-trained Transformers. High accuracy was observed in detecting conditions such as RA, SpAs and gout. The use of NLP also showed promise in managing diseases and predicting flares.</p><p><strong>Conclusion: </strong>NLP showed significant potential in enhancing rheumatology by improving diagnostic accuracy and personalizing patient care. While applications in detecting diseases like RA and gout are well developed, further research is needed to extend these technologies to rarer and more complex clinical conditions. Overcoming current limitations through targeted research is essential for fully realizing NLP's potential in clinical practice.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae120"},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the impact of COVID-19 lockdowns on fragility fracture risk and bone mineral density in a large observational cohort: a cross-sectional study.","authors":"Hamzah Amin, Muhammed Aqib Khan, Marwan Bukhari","doi":"10.1093/rap/rkae115","DOIUrl":"https://doi.org/10.1093/rap/rkae115","url":null,"abstract":"<p><strong>Objectives: </strong>Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2 or COVID-19) led to lockdowns predisposing people to sedentary lifestyles and unhealthy behaviours which may have affected bone mineral density (BMD) and fragility fracture risk. However, limited studies describe such an association. We aimed to investigate how COVID-19 lockdowns has affected BMD and fragility fractures in a large cohort.</p><p><strong>Methods: </strong>Patients were referred to our DXA scanner from 2004 to 2024 and were subsequently categorized as pre- or post-March 23, 2020 (pre- and post-COVID-19) to allow analysis between the groups. Demographic, BMD and compositional data were compared between the two populations. A multivariate logistic regression modelled the odds of reporting a fracture including hip and non-hip fracture. A multiple linear regression was used to model how the lockdown has affected bone density. All analyses were adjusted for confounders.</p><p><strong>Results: </strong>Of 43 799 referrals, 6564 were post-COVID-19. Post-COVID-19 patients had higher non-hip fracture rates (42.0% vs 39.8%), were 3 kg heavier, and had lower left femoral T-scores. Patients referred post-COVID-19 had a statistically significant reduction of -0.23 to their T-score after adjusting for confounders as well as increased risk of getting diagnosed with osteoporosis [odds ratio (OR) 1.49, 95% CI 1.40-1.59]. Patients referred after the pandemic had a reduced odds of any fracture (OR 0.83, 95% CI 0.77-0.88), hip (OR 0.74, 95% CI 0.62-0.88) and non-hip fracture (OR 0.78, 95% CI 0.73-0.83).</p><p><strong>Conclusion: </strong>COVID-19 lockdowns may have negatively affected bone; however, this has not translated to an increased fracture risk in our study. Further research is needed with prospective cohorts to corroborate this risk.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae115"},"PeriodicalIF":2.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undergraduate rheumatology teaching in the UK: a survey of current practice by teachers and students.","authors":"Pippa Watson, David Hanna, Sophia M Wakefield, David Coady, Donna Andrew, Daisy Southam, Richard J Wakefield","doi":"10.1093/rap/rkae112","DOIUrl":"https://doi.org/10.1093/rap/rkae112","url":null,"abstract":"<p><strong>Objectives: </strong>The last major UK survey of medical undergraduate rheumatology teaching was 25 years ago. This study aimed to describe current teaching practice, the perceptions of teachers and students and their engagement with Versus Arthritis teaching resources and future challenges and opportunities.</p><p><strong>Methods: </strong>Electronic surveys were distributed by e-mail and/or social media to relevant teachers and students identified within all 37 UK medical schools.</p><p><strong>Results: </strong>A total of 34/37 (91%) teacher and 30/37 (81%) student surveys were returned. Compared with the last survey, the proportion of schools delivering rheumatology-identifiable teaching has fallen from 100% to 86% and the mean number of teaching days from 30 to 10. Rheumatology teaching is now more dispersed throughout the curriculum. Students preferred active learning methods such as simulation and expert patient teaching, while teachers preferred small-group teaching, online learning and lectures. The Versus Arthritis resources appeared underutilized by students but were considered useful. Most students thought rheumatology careers were not promoted within their medical school.</p><p><strong>Conclusion: </strong>A decrease in dedicated rheumatology teaching time was noted since the last survey 25 years ago. Greater promotion of rheumatology as a speciality and future career is required to maintain its professional identity and prevent marginalization.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae112"},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High risk of misclassification of acute Parvovirus B19 infection into a systemic rheumatic disease.","authors":"Bernardo D'Onofrio, Giulia Virelli, Elisa Pedrollo, Marta Caprioli, Marta Riva, Daniela Renna, Antonio Tonutti, Nicoletta Luciano, Angela Ceribelli, Elisa Gremese, Maria De Santis, Carlo Selmi","doi":"10.1093/rap/rkae105","DOIUrl":"https://doi.org/10.1093/rap/rkae105","url":null,"abstract":"<p><strong>Objectives: </strong>Parvovirus B19 most frequently causes epidemics of erythema infectiosum in children but also affects adults often leading to rheumatologic manifestations. While the serum profile allows the diagnosis, manifestations may mimic autoimmune conditions. The aim was to evaluate the proportion of patients with acute Parvovirus B19 infection fulfilling classification criteria for rheumatic diseases (RA and SLE).</p><p><strong>Methods: </strong>We evaluated the clinical and serological features of 54 patients diagnosed with acute Parvovirus B19 infection seeking rheumatological attention between March and June 2024.</p><p><strong>Results: </strong>The majority of patients were females (78%), with a mean (s.d.) age of 45 (13) years and 54% could not recall any known exposure. Fifty-one/54 (94%) had arthralgia, 27 (50%) arthritis (oligoarthritis in 67% of them), 24 (44%) fever, 19 (35%) skin rash and 7 (13%) purpura. Symptoms resolution generally occurred within 6 weeks. Complement levels were low in 14/33 (42%) tested patients, while the presence of serum ANA, anti-dsDNA, anti-phospholipids and rheumatoid factor was detected in 21/38 (55%), 10/26 (38%), 6/12 (50%) and 5/37 (13%) patients, respectively. Classification criteria for SLE were fulfilled in 93% of ANA-positive patients and RA criteria in 38% of patients with arthritis.</p><p><strong>Conclusions: </strong>Parvovirus B19 infection manifestations may vary and nearly all patients with positive serum ANA fulfil the classification criteria for SLE. The risk of misclassification in patients with viral infection should not be overlooked.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 3","pages":"rkae105"},"PeriodicalIF":2.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world data on tolerability of COVID-19 vaccination in patients with rheumatoid arthritis based on patient-reported outcomes.","authors":"Martin Feuchtenberger, Magdolna Szilvia Kovacs, Anna Eder, Axel Nigg, Giovanni Almanzar, Martina Prelog, Arne Schäfer","doi":"10.1093/rap/rkae111","DOIUrl":"https://doi.org/10.1093/rap/rkae111","url":null,"abstract":"<p><strong>Objectives: </strong>To assess tolerability of COVID-19 vaccination in patients with RA and controls based on patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>In total, 266 study participants were included at 6 ± 1 weeks after their second vaccination (BioNTech/Pfizer (72.2%), AstraZeneca (18.8%) and Moderna (9.0%)). In a cross-sectional, observational study design, PRO data were recorded regarding both total and symptom-level tolerability.</p><p><strong>Results: </strong>Overall tolerability was very high according to the patients' self-assessment scores (1.71 for the first and 1.72 for the second vaccination, 6-point Likert scale [1 (very good) to 6 (very poor)]) and did not differ significantly between patients with RA (<i>n</i> = 204) and controls (<i>n</i> = 62). Self-rated overall tolerability regarding first vaccination was significantly better (<i>P</i> = 0.002) in patients receiving mRNA vaccines (<i>n</i> = 193, mean tolerability 1.59) as compared with vector-vaccinated patients (<i>n</i> = 73, mean tolerability 2.04). Homologous or heterologous vaccination regimens had no statistically significant effect on vaccine tolerability (<i>P</i> = 0.131). Reservations about the vaccination were rare (6.4% for the first and 6.0% for the second vaccination) but significantly associated with poorer overall tolerability (<i>P</i> < 0.001) and significantly reduced willingness to recommend vaccination to others (<i>P</i> < 0.001 for the first and <i>P</i> = 0.004 for the second vaccination).</p><p><strong>Conclusion: </strong>Based on these real-world data, tolerability of COVID-19 vaccination was very good in both RA patients and controls. Reservations against COVID-19 vaccination were rare overall, but if present, associated with a significantly worse tolerability and a significantly lower degree of recommendation.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae111"},"PeriodicalIF":2.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined associations of obesity and physical activity with pain, fatigue, stiffness and anxiety in adults with spondyloarthropathies: UK Biobank study.","authors":"Matthew J Roberts, William Johnson, Sepehr Qooja, Arumugam Moorthy, Nicolette C Bishop","doi":"10.1093/rap/rkae109","DOIUrl":"https://doi.org/10.1093/rap/rkae109","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory spondyloarthropathies are associated with pain, fatigue, stiffness and anxiety. The National Institute for Health and Care Excellence and the EULAR provide limited lifestyle guidance for managing symptoms with inflammatory spondyloarthropathies. We investigated the combined associations of obesity and physical activity with symptom severity in inflammatory spondyloarthropathies.</p><p><strong>Methods: </strong>The relationship between BMI, physical activity and symptom severity (spinal and general pain, fatigue, anxiety, mobility) was examined in people with ISpAs (<i>n</i> = 1577). BMI categories were normal weight (18.5-24.9 kg/m²), overweight (25.0-29.9 kg/m²) and obese (≥30 kg/m²). Physical activity was assessed via the International Physical Activity Questionnaire (low < 600 metabolic equivalent of task (MET)-min/week, moderate ≥ 600 METs, high ≥ 3000 METs). Statistical models adjusted for confounders, including medication, estimated the likelihood (odds ratios, OR) of higher symptom severity across BMI and physical activity categories.</p><p><strong>Results: </strong>Overweight and obesity, compared with normal weight, were linked to higher severity of all symptoms, with stronger associations for obesity (OR ≥ 2.34, <i>P</i> < 0.001) than overweight (OR ≥ 1.37, <i>P</i> ≤ 0.032). Moderate activity, compared with low, was associated with lower severity of all symptoms (OR ≤ 0.77, <i>P</i> ≤ 0.032). High activity, compared with low, was associated with lower severity of fatigue, anxiety and mobility issues (OR ≤ 0.74, <i>P</i> ≤ 0.029), but associations with spinal and general pain were not significant (OR ≤ 0.80, <i>P</i> ≥ 0.056). No BMI-by-physical activity combinations were detected, indicating physical activity benefits all BMI groups to a similar extent.</p><p><strong>Conclusion: </strong>National Institute for Health and Care Excellence and EULAR guidance for inflammatory spondyloarthropathies should emphasize maintaining a normal weight. Moderate physical activity is optimal for reducing symptom severity and should be promoted in lifestyle guidance.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae109"},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Initiated Follow-Up (PIFU): how can rheumatology departments start to reap the benefits? A consensus document.","authors":"Raj Sengupta, Marwan Bukhari, Zoe Cole, Stuart Kyle, Gordon MacDonald, Kirsten McKay, Anushka Irani, Mark Perry","doi":"10.1093/rap/rkae091","DOIUrl":"https://doi.org/10.1093/rap/rkae091","url":null,"abstract":"<p><p>Patient Initiated Follow-Up (PIFU) is gaining momentum in the NHS, aiming to optimize outpatient care amidst rising service demands. PIFU is valuable in rheumatology, where the increasing demand for ongoing management exacerbates the patient backlog. Importantly, PIFU has demonstrated comparable safety and outcomes to traditional care in numerous studies. PIFU empowers patients, drives personalized care, increases efficiency, and has the potential to reduce waiting lists by allowing services to focus on new and acute cases. Effective PIFU implementation includes careful selection of patients, educating patients and healthcare staff, well defined operational guidelines, and robust remote monitoring. Digital solutions can enhance PIFU through patient education, active remote monitoring and streamlined escalation. Electronic Patient Reported Outcome Measures (ePROMs) provide a suitable and safe metric to monitor patients remotely. Given the potential benefits, outpatient departments should consider investing in PIFU as a solution to current healthcare delivery challenges and as a means for future proofing clinical systems against increasing service demands.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae091"},"PeriodicalIF":2.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}