“For patients with rheumatic and musculoskeletal diseases, we want to encourage a sustained physical activity behavior change,” writes Dr. Golightly in an email. “Starting any new exercise program slowly is important for minimizing soreness and to build confidence in their ability to exercise.
“Therapeutic exercise programs include resistance training, aerobic activities (e.g., walking or cycling), balance activities and exercises aimed at maintaining or increasing range of motion. These programs should be tailored to the individual’s abilities and goals, and patient education, along with regular reassessments by the healthcare provider, can guide safe progression of the exercises.”
Down & Dirty 30: RA from Diagnosis to Treatment
Monica Richey, BSN, MSN, ANP-BC, GNP, will talk about RA and steps to advance patient care from diagnosis to treatment and beyond. A nurse practitioner with Northwell Health, New York, Ms. Richey has gained valuable insight from years of working directly with patients, including her annual, weeklong visits to South Dakota to provide much needed treatment to Native Americans.
“It really sharpens your clinical skills,” says Ms. Richey of her work at the Pine Ridge Reservation, because normal resources are limited, and patients typically don’t have access to medical specialists. “You have to trust your clinical judgment to make the diagnosis and make a long-term plan. You see that patient once, plan what’s going to happen for the whole year and leave it all in the notes so the primary care [professional] can follow your steps.”
During her ACR Convergence 2020 session, Ms. Richey plans to examine the normal evolution of RA and will likely present a case study to illustrate key stages, she says. Her talk will cover steps to take when a patient presents with symptoms, understanding X-rays, laboratory results and other diagnostic tools, a review of ACR treatment guidelines and the necessity of monitoring patient therapy.
“Monitoring is very important,” says Ms. Richey, because therapy can have side effects, such as elevated lipids, neutropenia and transaminitis. Even if a patient is stable, monitoring is needed to ensure a medication is working and to identify unwanted, unexpected or harmful effects.
With an emphasis on current treatment guidelines, the presentation will speak to the professional interests of nurses, pharmacists, new fellows just starting their careers or anyone who wants to learn more about the initial diagnosis, progression of treatment and progression of the disease itself.
Down & Dirty 30: Psoriatic Arthritis
Daniela Schwartz, MD, assistant clinical investigator at the National Institutes of Health’s (NIH) National Institute of Allergy and Infectious Diseases, will present the psoriatic arthritis session. In her work for the NIH, she investigates the regulation and roles of allergy-associated cytokines in rheumatic diseases, including psoriasis and psoriatic arthritis, according to Ann Biehl, MS, PharmD, a member of the Annual Meeting Planning Committee.
