A typical patient with a rheumatic disease needs a multifaceted treatment approach to address comorbidities, minimize disability, promote quality of life and improve survival. To achieve these outcomes, rheumatology research has evolved from examining a single treatment to studying the best treatment approaches. Examples of these strategy trials include how to best combine pharmaceutical therapies, identifying which treatments are best used after traditional disease-modifying agents lose efficacy, studying the utility of non-pharmaceutical approaches for rheumatic diseases and identifying the optimal treatment target for disease management.1-10
Explore this issueDecember 2018
The next generation of strategy trials will incorporate patient preferences, evaluate shared decision making and include societal/payer preferences for value-based decisions on specific interventions.11-15
Despite advances in research strategies, significant gaps in rheumatology care exist within our communities, particularly related to such patient-reported outcomes as pain.
Community-based rheumatology care has several challenges, including lack of resources to support treatment, lack of integrated, team-based models of care, long wait times to access a rheumatologist and a paucity of pain management strategies for most inflammatory rheumatic diseases.16