Arthritis Care & Research最新文献

{"title":"Real-World Cost-Effectiveness of a Standardized Education and Exercise Therapy Program Hip and Knee Osteoarthritis Compared to Usual Care.","authors":"Darren R Mazzei, Jackie L Whittaker, Peter Faris, Tracy Wasylak, Deborah A Marshall","doi":"10.1002/acr.25555","DOIUrl":"https://doi.org/10.1002/acr.25555","url":null,"abstract":"<p><strong>Objective: </strong>We estimated the real-world cost-effectiveness of a standardized education and exercise therapy program (GLA:D®) compared to usual care (UC) for people managing hip and/or knee osteoarthritis (HKOA).</p><p><strong>Methods: </strong>We used a prospective matched cohort design to recruit people (age>45 years) diagnosed with HKOA who used GLA:D® or UC (not on a surgical waitlist) throughout Alberta, Canada. Demographics, pain, function, quality of life, and an HKOA-related cost questionnaire were administered over 12 months. The primary Ministry of Health (MOH) perspective used administrative data to estimate all public healthcare costs. The secondary healthcare perspective included MOH, private insurance, and out-of-pocket costs. We calculated our cost-effectiveness measure, incremental net monetary benefit (INMB), over 12 months with a $30,000/QALY willingness to pay threshold and adjusted for the differences between cohorts. A Markov model was used to extend INMB over a lifetime time horizon (3% discounting). Model uncertainty was explored by probabilistic sensitivity analyses.</p><p><strong>Results: </strong>254 participants (GLA:D® n=127, UC n=127; 72% female), with a mean age of 64.3 years (95%CI:63.1-65.5), diagnosed with knee OA (63%), hip OA (24%) or both (13%) for a mean of 5.5 years (95%CI:4.8-6.3). The adjusted INMB of GLA:D® compared to UC was $6,065 (95%CI:$3,648-$8,482) and $499 (95%CI:-$2,913-$3,912) from a MOH and healthcare perspective over 12 months and $6,574 and $1,775 over a lifetime with 54% and 51% probability of being cost-effective using a threshold of willingness to pay of $30,000 per QALY.</p><p><strong>Conclusions: </strong>GLA:D® had a positive INMB compared to UC from the MOH perspective over 12 months. The INMB remained positive but was less certain over a lifetime or when out-of-pocket and private insurance costs were considered.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, Usability, and Validity Evidence of a Rheumatology Telehealth Feedback Form.","authors":"Lisa Zickuhr, Alberto Sobrero, Daniel Albert, Amanda S Alexander, Tami Bonnett-Ami, Sarah Dill, Sharon Dowell, Elizabeth D Ferucci, Connie Herndon, Bharat Kumar, David Leverenz, Jennifer Mandal, Amaad Rana, Irene J Tan, Swamy Venuturupalli, Tiffany Westrich-Robertson, Marcy B Bolster, Jason Kolfenbach","doi":"10.1002/acr.25552","DOIUrl":"10.1002/acr.25552","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatology telehealth is widespread, making it essential that rheumatology fellows-in-training (FITs) achieve competence delivering telehealth care before entering the workforce. Feedback enhances telehealth skill development. This study develops a Rheumatology Telehealth Feedback Form (RTFF) that incorporates existing data and expertise as well as gathers validity evidence supporting its use.</p><p><strong>Methods: </strong>The American College of Rheumatology Workforce Solutions Committee formed a working group with expertise in rheumatic diseases, telehealth, and medical education. The working group conducted a modified Delphi and focus groups to define content grounded in Rheumatology Telehealth Competencies and evidence-based practice as well as develop the RTFF. Rheumatology educators and FITs piloted the RTFF during patient care and simulated telehealth encounters, rating the helpfulness of the RTFF and providing data to calculate intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>The modified Delphi identified 16 skills essential to conducting rheumatology telehealth encounters, which were converted into 17 items on the RTFF. Comment boxes prompted supplementary narrative. Five educators and 10 FITs piloted the materials. All educators (5 of 5) \"agreed\" or \"strongly agreed\" that the RTFF helped teach rheumatology telehealth skills. ICCs calculated from two simulated telehealth encounters demonstrated moderately to strongly supportive interrater reliability (ICC = 0.857 and 0.632, respectively).</p><p><strong>Conclusion: </strong>The RTFF incorporates an evidence-based, expert consensus of the skills most essential for rheumatology telehealth encounters. Educators can use the RTFF as a guide for observing FITs delivering telehealth care, providing formative feedback, and helping FITs develop their skills before entering the workforce. The RTFF is the first direct observation formative assessment tool designed for teaching rheumatology telehealth skills.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Perforation as a Safety Concern Among Patients With Rheumatoid Arthritis Receiving JAK Inhibitor Therapy: A Systematic Review and Network Meta-Analysis.","authors":"Thipsukhon Sathapanasiri, Manuel Meraz, Hamraz Mokri, Sajesh K Veettil, Karn Wijarnpreecha, Naomi Schlesinger, Arthur Kavanaugh, Nathorn Chaiyakunapruk","doi":"10.1002/acr.25554","DOIUrl":"10.1002/acr.25554","url":null,"abstract":"<p><strong>Objective: </strong>Gastrointestinal perforation (GIP) is a rare and life-threatening safety concern associated with JAK inhibitors (JAKi). We aimed to review the evidence regarding the risk of GIP associated with the use of JAKi in patients with rheumatoid arthritis (RA) using a systematic review and network meta-analysis approach.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov through August 2024. Included were randomized controlled trials (RCTs) comparing JAKi with other comparators in adult patients with RA (age ≥18 years) and reports of GIP. Risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using a random-effects model. Surface under the cumulative ranking curves (SUCRA) were used to rank interventions.</p><p><strong>Results: </strong>A total of 23 RCTs involving 20,023 patients were included, with a median follow-up time of 24 weeks. The overall incidence of GIP among JAKi-treated patients was 0.19% (95% CI 0.10-0.35%), with 24 events occurring out of 12,430 patients. Pairwise meta-analysis showed that the risk of GIP among patients taking JAKi was not significantly increased compared to that in those taking conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (RR 1.02; 95% CI 0.41-2.56; I² = 0.0%). The results of the network meta-analysis are consistent with the pairwise meta-analysis findings. Compared to csDMARDs, there was no statistically significant increase in GIP risk with JAKi (RR 0.83; 95% CI 0.37-1.84; P = 0.64) without inconsistency (P = 0.55). The SUCRA of JAKi (50.8%) and biologic DMARDs (77.0%) indicated a low risk of GIP.</p><p><strong>Conclusion: </strong>JAKi were not associated with an increased risk of GIP compared to csDMARDs in patients with RA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Year Follow-Up of a Multidisciplinary Lifestyle Intervention for Rheumatoid Arthritis and Osteoarthritis.","authors":"Carlijn A Wagenaar, Wendy Walrabenstein, Marike van der Leeden, Franktien Turkstra, Martijn Gerritsen, Jos W R Twisk, Maarten Boers, Martin van der Esch, Henriët van Middendorp, Peter J M Weijs, Dirkjan van Schaardenburg","doi":"10.1002/acr.25553","DOIUrl":"10.1002/acr.25553","url":null,"abstract":"<p><strong>Objective: </strong>The Plants for Joints (PFJ) intervention, including a whole-food plant-based diet, exercise, and stress reduction, reduced signs and symptoms of rheumatoid arthritis (RA) or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared to usual care. This study aimed to examine outcomes two years after the PFJ intervention.</p><p><strong>Methods: </strong>After two 16-week randomized controlled trials in people with (1) RA or (2) MSOA, control groups received the active PFJ intervention. All participants were then observed in a two-year observational extension study. Primary outcomes were Disease Activity Score in 28 joints (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes, and adherence to intervention recommendations. Within-group differences were assessed using linear mixed models, comparing the start and end of the intervention to two years after intervention.</p><p><strong>Results: </strong>A total of 48 of 77 participants with RA (62%) and 44 of 64 participants with MSOA (69%) completed the extension study. Two years after the intervention, the DAS28 in participants with RA (-0.9 points, 95% confidence interval [CI] -1.2 to -0.6 points) and WOMAC score in participants with MSOA (-8.8 points, 95% CI -12.6 to -5.1 points) were significantly lower than start intervention. In addition, C-reactive protein in the RA group and weight, body mass index, waist circumference, and diastolic blood pressure in the MSOA group were significantly lower compared to start intervention. Primary end points remained similar from the end of the intervention to the end of the extension study. During the extension study, medication use decreased slightly, and participants continued to follow the intervention recommendations.</p><p><strong>Conclusion: </strong>Two years after the PFJ intervention, improvements in RA disease activity, MSOA symptoms and functioning, and intervention adherence were sustained.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Rheumatology Clinical Research Year in Review, 2023-2024.","authors":"Natasha M Ruth","doi":"10.1002/acr.25549","DOIUrl":"https://doi.org/10.1002/acr.25549","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colchicine Concentrations and Relationship With Colchicine Efficacy and Adverse Events: Post Hoc Analysis of a Randomized Clinical Trial of Colchicine for Gout Flare Prophylaxis.","authors":"Lisa K Stamp, Anne Horne, Borislav Mihov, Jill Drake, Janine Haslett, Peter Chapman, Daniel F B Wright, Christopher Frampton, Nicola Dalbeth","doi":"10.1002/acr.25548","DOIUrl":"10.1002/acr.25548","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to examine the relationship between colchicine plasma concentrations and clinical and demographic factors and to determine the relationship between colchicine concentrations and colchicine efficacy and colchicine-specific adverse events.</p><p><strong>Methods: </strong>Post hoc analyses were undertaken using data from a 12-month randomized controlled trial involving 200 people with gout that compared low-dose colchicine to placebo for the first six months while starting allopurinol, with a further six-month follow-up. Steady-state colchicine plasma concentrations were measured 30 to 80 minutes post dose (assumed peak) and just before the dose (trough) at month three, and creatine kinase (CK) levels were measured at months zero, three, and six. Self-reported gout flares, adverse events, and serious adverse events were collected monthly.</p><p><strong>Results: </strong>Peak and trough colchicine concentrations were available for 79 participants in the colchicine arm. Multivariable analysis showed that those taking a statin and non-Māori and non-Pacific ethnicity were independently associated with higher trough concentrations, and age older than 60 years was independently associated with higher peak concentrations. Trough and peak colchicine concentrations were significantly higher in those who had any adverse event between months four and six. However, there was no association between colchicine concentrations and colchicine-specific adverse events (gastrointestinal and muscle) or with CK changes in the colchicine-treated patients.</p><p><strong>Conclusion: </strong>Trough or peak colchicine concentrations are not associated with gout flare prophylaxis efficacy. There is no consistent relationship between colchicine concentrations and colchicine-specific adverse events. Although colchicine concentrations increase with concomitant statin use, this does not result in muscle-related adverse events. These findings indicate that colchicine therapeutic drug monitoring is of limited value in clinical practice.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Letter in Support of Advocating for the Whole Patient: Supporting New Guidance on Mental Health in Pediatric Rheumatology.","authors":"Suzanne Edison, Natasha Trehan, Kathleen A Arntsen, Kate Anastasia, Jennifer Wilson, Alexander C Theos, Louise Vetter, Paul Larkin","doi":"10.1002/acr.25551","DOIUrl":"10.1002/acr.25551","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Contributors of Resilience in Youth With Childhood-Onset Systemic Lupus Erythematosus Through a Socioecological Lens: A Mixed-Methods Study.","authors":"Isabella Zaffino, Louise Boulard, Joanna Law, Asha Jeyanathan, Lawrence Ng, Sandra Williams-Reid, Kiah Reid, Angela Cortes, Eugene Cortes, Ashley Danguecan, Deborah M Levy, Linda T Hiraki, Andrea M Knight","doi":"10.1002/acr.25550","DOIUrl":"10.1002/acr.25550","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify themes contributing to resilience in childhood-onset systemic lupus erythematosus (cSLE), distinguish between profiles of resilience, and examine how they relate to underlying themes and patient characteristics.</p><p><strong>Methods: </strong>We conducted a mixed-methods study of 21 patients with cSLE aged 11 to 19 years at a Canadian tertiary care center from October 2022 to July 2024. We purposively sampled patients belonging to ethnically and culturally diverse backgrounds to complete semistructured interviews. We qualitatively defined features of resilience and distinguished profiles of low versus high socioecological resilience according to patient median on the Child and Youth Resilience Measure-Revised (CYRM-R). Profiles were then related to sociodemographic (eg, adverse childhood experiences, health literacy), disease features (eg, age at diagnosis, disease duration), and patient-reported outcomes (eg, anxiety and depressive symptoms).</p><p><strong>Results: </strong>Factors contributing to resilience were grouped into five themes: familial environment, social support beyond family, health services and information, life with SLE, and sense of self. Cultural influences were reported to impact several themes. Patients with high resilience (scores above 73 on CYRM-R) reported more facilitators in each thematic area, whereas patients with low resilience experienced more challenges in these areas, in addition to greater number of adverse childhood experiences, lower health literacy, earlier age at diagnosis, longer disease duration and poorer mental health.</p><p><strong>Conclusion: </strong>Findings support a dynamic model of resilience, shaped by a combination of sociodemographic, disease, personal, cultural and social factors. This improved understanding of resilience may help direct comprehensive care for youth with cSLE and guide targeted interventions for youth at risk of poor outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Hepatotoxicity in Patients With Gout Treated With Febuxostat or Benzbromarone: A Propensity Score-Matched Cohort Study.","authors":"Wenyan Sun, Lingling Cui, Robert Terkeltaub, Ying Chen, Xinde Li, Xiaoyu Cheng, Tian Liu, Nicola Dalbeth, Changgui Li","doi":"10.1002/acr.25547","DOIUrl":"10.1002/acr.25547","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate and compare the risk of hepatotoxicity associated with the use of febuxostat and benzbromarone in patients with gout.</p><p><strong>Methods: </strong>New users of febuxostat or benzbromarone with monitoring of liver function at least three times in a year after initiation of the study drugs were identified from an electronic medical record database. Propensity score matching (PSM) was performed between the two groups 1:1 matched for age, sex, and pretreatment alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Kaplan-Meier analysis was used to estimate the probability of hepatotoxicity (defined as ALT or AST > 3× upper limit of normal). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression. Subgroup analysis was performed based on age, body mass index, and comorbidities.</p><p><strong>Results: </strong>A total of 2,338 patients with gout were eligible. A total of 37% of patients experienced Common Terminology Criteria for Adverse Events version 5 grades 1 to 3 for AST or ALT abnormality. After PSM, 488 febuxostat users were matched, with 488 participants receiving benzbromarone with a mean follow-up of 1.20 years. The incidence of hepatotoxicity was 39.6 and 16.8 per 1,000 person-years for febuxostat users and benzbromarone users, respectively. Febuxostat use was associated with a significantly greater risk of hepatotoxicity than benzbromarone (adjusted HR 2.75, 95% CI 1.28-5.91), especially in patients with elevated transaminases at baseline. Findings did not differ according to prespecified subgroups.</p><p><strong>Conclusion: </strong>Febuxostat use is associated with a significantly greater risk of mild-to-moderate perturbation of liver function compared to benzbromarone in patients with gout.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Stress and Prediction of Worse Patient-Reported Outcomes in a Rheumatoid Arthritis Cohort.","authors":"Sarah L Patterson, Joonsuk Park, Wendy Hartogensis, Patricia Katz","doi":"10.1002/acr.25543","DOIUrl":"10.1002/acr.25543","url":null,"abstract":"<p><strong>Objective: </strong>Studies have suggested a potential link among traumatic experiences, psychologic stress, and autoimmunity, but the impact of stress on disease activity and symptom severity in rheumatoid arthritis (RA) remains unclear. We examined whether perceived stress independently associates with worse RA disease outcomes at subsequent visits over 18 months of follow-up.</p><p><strong>Methods: </strong>Participants were enrolled in a longitudinal RA cohort with study assessments every six months. We measured stress via the four-item Perceived Stress Scale and the following disease outcomes: patient-reported disease activity (Rheumatoid Arthritis Disease Activity Index), pain (Patient-Reported Outcome Measurement Information System [PROMIS] Pain Interference), fatigue (PROMIS Fatigue), and physical function (PROMIS Physical Function). Time-lagged linear mixed effects models evaluated longitudinal associations of stress with all four outcomes at the subsequent time point while controlling for potential confounders.</p><p><strong>Results: </strong>The sample (N = 133) was 88% female, 45% White, 35% Hispanic, 9% African American, and 6% Asian American; the mean ± SD age was 58 ± 13 years. In adjusted time-lagged longitudinal analyses, stress independently associated with greater self-reported disease activity (β = 0.11, 95% confidence interval [CI] 0.03-0.19), more pain (β = 0.61, 95% CI 0.29-0.94), more fatigue (β = 0.71, 95% CI 0.32-1.11), and lower physical function (β = -0.33, 95% CI -0.59 to -0.06). The effect size represented clinically significant differences for pain, fatigue, and physical function, but not disease activity.</p><p><strong>Conclusion: </strong>Among a longitudinal RA cohort, those with greater perceived stress had worse pain, greater fatigue, and lower physical function at follow-up. Findings underscore the need to integrate stress resilience interventions and programs that augment psychosocial support in health care systems that serve people living with RA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}