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Midlevel Providers Could Help Ease Shortages in Rheumatology

Further increasing number of rheumatology NPs, PAs could enhance access to care

FRIDAY, Aug. 1, 2014 (HealthDay News) -- Nurse practitioners and physician assistants report a high level of independence and broad responsibilities in rheumatology practice, and may help to reduce shortages in the rheumatology workforce, according to a study published in the July issue of Arthritis Care & Research.

Daniel H. Solomon, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues surveyed midlevel providers during 2012 regarding level of practice independence, responsibilities, drug prescribing, use of objective outcome measures, and knowledge and use of treat-to-target (TTT) strategies.

Based on 174 responses (mean age 46 years; 83 percent women), the researchers found that three-quarters had ≤10 years of experience and 53 percent received formal training in rheumatology. Almost two-thirds reported having their own panel of patients. Performing patient education, adjusting medication doses, and conducting physical examinations were the top three practice responsibilities for nearly all respondents. The majority (>90 percent) felt very or somewhat comfortable diagnosing rheumatoid arthritis and had prescribed disease-modifying antirheumatic drugs. While three-quarters reported using disease activity measures for rheumatoid arthritis, just over half (56 percent) reported that their practices used TTT strategies.

"These data suggest midlevel providers may help to reduce shortages in the rheumatology workforce and conform with recommendations to employ TTT strategies in RA treatment," the authors write.

One author disclosed financial ties to the pharmaceutical industry

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