Recomendaciones SER sobre el manejo de los pacientes con fibromialgia. Parte II: educación del paciente y formación de los profesionales

ObjectiveTo prevent the deterioration of patients with fibromyalgia due to potentially avoidable harmful actions in clinical practice.MethodsA multidisciplinary panel of experts identified key areas, analysed the scientific evidence and formulated recommendations based on this evidence and qualitative techniques of «formal assessment» or «reasoned judgement».ResultsThirty-nine recommendations were made on diagnosis, ineffective and unsafe treatments, patient education and practitioner training. This part II shows the 12 recommendations, referring to the latter two areas.ConclusionsGood knowledge of fibromyalgia on the part of patients improves their coping and acceptance of the disease and reduces the severity of some clinical manifestations. Healthcare professionals treating patients with fibromyalgia should be well trained in this disease to improve treatment outcomes and patient relationships.     

Calidad percibida de formación en ecografía musculoesquelética en los servicios de reumatología españoles

Background and objectiveUltrasound has been included in the training of residents in rheumatology in recent years, as a result of its increased use in daily clinical practice. Our objective is to evaluate the perceived quality of ultrasound training of residents in rheumatology services in Spain.Material and methodsOnline survey aimed at rheumatologists who began their training in rheumatology between 2009 and 2019.ResultsOne hundred thirty-nine rheumatologists participated in the survey, of which 97.1% had at least one ultrasound machine in their training centre. Up to 51.1% performed a rotation in ultrasound and 56% had an ultrasound consultation. Access to SER courses was high (87.8%) while access to EULAR courses was limited (17.3%) and up to 69.1% of residents did not complete the competency accreditation. Training in evaluation of inflammatory joint activity, entheses and microcrystalline diseases received the highest scores. Evaluation of ultrasound training during the residency was good in 36% of cases, fair in 28.1%, poor in 18% and excellent in 12.9%. Of those surveyed, 88% consider their clinical practice as a rheumatologist to have improved.ConclusionsMost residents have performed ultrasound rotations. Participation in SER ultrasound courses is high and moderate in EULAR courses, while only a minority completed the competency accreditation. The overall degree of satisfaction with training in ultrasound during residency is good and, in the opinion of residents, contributes to the improvement of their skills as rheumatologists.     

Telerreumatología en tiempos de crisis durante la pandemia por COVID-19

IntroductionDuring the COVID-19 pandemic strategies to prevent transmission of the viral infection obliged our hospital to promote virtual consultations.ObjetiveThe objective of this study is to describe the results obtained with the previous strategy of transferring activity to teleconsultation during the period of maximum impact of the pandemic.Material and methodsBetween 16/03 and 10/05/2020 all successive consultations in our unit were performed in virtual rheumatology teleconference (RTC) format. The socio-demographic, geo-functional and clinical characteristics of all patients were collected; a numeric verbal scale (NVS) (where 0=very dissatisfied to 10=fully satisfied) was applied to assess the degree of satisfaction of the doctor/patient with the RTC.Results469 TC were included. Most patients seen by RTC were women, mean age: 60,83 years. Only 16% had university education. The mean distance travelled for face-to face consultation is 33 Km with a mean total time of 2 hours. Most individuals were diagnosed with osteoarthritis/soft tissue rheumatic diseases and/or osteoporosis; 21% had rheumatoid arthritis. The mean length of the TC was 9.64 minutes. We find more patient satisfaction with the TC when their level of education is higher (OR=4.12); doctor satisfaction was higher when the individual was better able to manage the Internet (OR=3.01).ConclusionIt is possible to transfer rheumatological care activity to TC with a considerable degree of satisfaction for both the patient and the doctor.     

Formación posgrado en Reumatología: perspectiva en Europa

The aims, structure and content of postgraduate training programs in rheumatology remain under the domain of national authorities. Data comparing training standards in rheumatology among different countries are scarce but suggest marked variability at a structural level and possibly in the competencies acquired during the training. However, a certain degree of harmonization throughout Europe would support the free movement of medical specialists within the European Union and would help guarantee minimum quality standards. The Rheumatology Section of the European Union of Medical Specialists (EUMS) has generated European recommendations for training in rheumatology but the general opinion is that their inclusion in the national curricula has been slow and limited.     

Evaluating the impact of global awareness days on rheumatological search interest before and during the coronavirus-19 (COVID-19) pandemic

Aim of the workWe assessed the online efficacy of global awareness days (GADs) related to 5 rheumatological conditions: ankylosing spondylitis, fibromyalgia, gout, osteoporosis, and rheumatoid arthritis before and during the COVID-19 pandemic.MethodsGoogle Trends was used to obtain global relative search volume (RSV) for each condition, for a 41-day period around each GAD, per annum, between the years 2015 and 2020, inclusive. A joinpoint (time-trend) analysis was subsequently used to identify statistically significant perturbations (p < 0.05) in the overall RSV trend for the 41-day period, per condition, per annum.ResultsBetween the years 2015 and 2019, inclusive, we found that only 1 out of 5 rheumatological conditions was associated with 3 joinpoints centred around the respective GAD. In contrast, for 2020, 3 out of 5 conditions were associated with 3 joinpoints centred around the respective GAD (p < 0.001, p = 0.03, p = 0.04, for fibromyalgia, gout, and osteoporosis respectively).ConclusionsGADs between the years 2015 and 2019, inclusive, were found to be inconsistent at increasing Google Interest (1 out of 5 conditions, per annum), but that GADs in 2020 were notably more consistent at increasing Google Interest (3 out of 5 conditions). This change in GAD efficacy described for 2020, at least in part, may be explained by the COVID-19 pandemic. Greater insight into how specific populations acquire health information could be leveraged into more effective health campaigns, with far-reaching benefits in screening, prevention, and early diagnosis.     

Clinical experience of IL-6 blockade in rheumatic diseases—Implications on IL-6 biology and disease pathogenesis

Interleukin 6 (IL-6) plays a significant role in many rheumatological diseases and has been described as both a pro- and anti-inflammatory cytokine. IL-6 blockade has been investigated in various rheumatic diseases and a humanised anti-IL-6 receptor antibody has been licensed for use in rheumatoid arthritis, systemic and polyarticular juvenile idiopathic arthritis. The increasing clinical experience of IL-6 blockade in rheumatic diseases adds to the existing knowledge regarding the physiological and pathological roles of IL-6.