| Differences in Treat-to-Target in Patients with Rheumatoid Arthritis versus Hypertension and Diabetes - Consequences for Clinical Care. | |
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MedLine Citation:
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PMID: 22035388 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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"Treat-to-target" of rheumatoid arthritis (RA) is similar in many respects to hypertension and diabetes. All three diseases involve a dysregulation of normal physiologic functions, which results in long-term organ damage if not treated. "Treat-to-target" strategies, based on values of specific quantitative measures, lead to improved outcomes, including longer survival. However, RA differs from hypertension and diabetes in at least fve important respects: 1. the absence of a single "gold standard" measure in RA for all individual patients necessitates indices; 2. the rarity of acute emergency situations in RA leads to underestimation of its natural history, which includes increased mortality rates similar to hypertension and diabetes; 3. the patient with hypertension or diabetes goes to the doctor to learn how she or he is doing, based on a "gold standard" quantitative measure, while the patient with RA goes to the doctor to tell the doctor how she or he is doing; 4. the history and physical examination in hypertension or diabetes may be recorded as narrative, nonquantitative information, as a vital sign or laboratory test provides the crucial information for clinical care but should be recorded as quantitative, standardized "scientifc" data on patient questionnaires and formal joint counts because of their importance in RA; and 5. patient mood or distress may impact directly RA indices used as quantitative measures in a "treat-to-target" strategy, which is not seen in hypertension or diabetes. These matters may be addressed through three global scales completed by health professionals concerning infammation, damage, or neither infammation nor damage as a basis for symptoms. |
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Authors:
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Isabel Castrejón; Theodore Pincus |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Bulletin of the NYU hospital for joint diseases Volume: 69 ISSN: 1936-9727 ISO Abbreviation: Bull NYU Hosp Jt Dis Publication Date: 2011 |
Date Detail:
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Created Date: 2011-10-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101300541 Medline TA: Bull NYU Hosp Jt Dis Country: United States |
Other Details:
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Languages: eng Pagination: 104-10 Citation Subset: IM |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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