Review of Current Workforce for Rheumatology in the Countries of the Americas 2012–2015

Reveille, John D.; Muñóz, Roberto; Soriano, Enrique R.; Albanese, Miguel; Espada, Graciela; Lozada, Carlos J.; Montúfar, Rubén; Neubarth, Fernando; Vásquez, Gloría; Zummer, Michel; Sheen, Rosa; Caballero-Uribe, Carlo V.; Pineda, Carlos

doi:10.1097/rhu.0000000000000465

Cited by 29 publications

(17 citation statements)

References 19 publications

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“…In agreement with reports from other continents (19)(20)(21) insufficient numbers of paediatric rheumatologists have been reported by more than 70% of both EEC and WEC, suggesting that the median number of 1.1 PR specialist physicians per 1 million inhabitants is insufficient. Differences regarding the definition of "paediatric rheumatologist" may account for this discrepancy.…”

Section: Discussionsupporting

confidence: 90%

The European network for care of children with paediatric rheumatic diseases: care across borders

et al. 2019

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Objectives: To provide an overview of the paediatric rheumatology (PR) care in Europe to inform future specialist service provision. Methods: An online survey was developed and presented to national coordinating centres of the Pediatric Rheumatology International Trials Organisation (PRINTO) representing a single EU member state (35 centres; Country survey); and to 288 individual PR centres (Centre and Disease Surveys) as a part of the EU project SHARE. The survey contained country and centre specific components covering organisation of PR care, composition of teams, education, healthcare and research facilities, and assessment of needs. The national coordinating centres completed both centre as well as country questions. Results: Response rates were 83% for Country and 57% for Centre surveys. Data from both surveys were itemised to organisational, quality of care and educational aspects. Across the EU, only one paediatric rheumatologist is available per million population, located in one of the 288 centres with specialised PR care. In all EU member states, there is overall good access to specialist care and to approved medications, although off-label medication availability is worse in Eastern European countries. Full financial coverage is provided for most prescribed medications. PR education is widely available for physicians but is insufficient for allied health professionals. Participation in clinical trials is generally high. Among important gaps identified, lack of widely accepted clinical guidelines/recommendations; and insufficient adolescent transition management planning were highlighted. Conclusions: This study provides a comprehensive analysis of specialist PR service provision across Europe. Seen from the perspective of health care providers, there are no major differences between EU member states. Rarity, chronicity and complexity of diseases form a major challenge to paediatric rheumatology care. Therefore, strengthening subspecialty networks (Paediatric Rheumatology European Society, PReS, PRINTO, and SHARE) and the recently created European Reference Networks (ERN) will facilitate provision an dissemination of standards of care and treatment recommendations to further improve patient-centred healthcare across Europe.

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Section: Discussionsupporting

confidence: 90%

The European network for care of children with paediatric rheumatic diseases: care across borders

et al. 2019

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“…Analyzing the 27 Brazilian States and the Federal District, ratios varied from 41,383 to 758,786 inhabitants per rheumatologist, displaying a positive correlation with the local gross domestic product and indices of human development [ 2 ]. This uneven distribution in Brazil mimics the situation in LA; variation from as low as 0.11 up to 4.83 rheumatologists per 100,000 inhabitants in Nicaragua and Uruguay, respectively—with the rheumatologists working predominantly in capitals and large cities—has been reported [ 1 ].…”

Section: Manpower Requirementsmentioning

confidence: 80%

“…In addition, their unequal distribution worsens the deficit. The vast majority of professionals work in urban areas of major cities, leaving a large number of individuals without access to rheumatologists [ 1 , 2 ]. Data from 2012 showed a mean ratio of 157,809 inhabitants per rheumatologist among 1229 rheumatologists practicing in Brazil.…”

Section: Manpower Requirementsmentioning

confidence: 99%

“…Considering that priorities vary within specific countries, it is difficult to evaluate challenges and demands affecting the Latin-American “subcontinent”. The present comment should be considered in the context of these limitations, given that an area comprising 19 countries and the Caribbean region, with circa 600 million inhabitants, has issues pertaining to specific countries and relevant variations within countries may apply [ 1 ].…”

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confidence: 99%

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Latin-American challenges and opportunities in rheumatology

Rocha

2017

Arthritis Res Ther

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The importance of diseases to mankind is very similar worldwide. However, social and environmental issues, not to mention political and individual aspects, affect the prevalence and management of diseases and their outcomes. I present a brief and tentative comment to illustrate that the Latin-American rheumatology community, despite relevant gains in recent years, has some challenges to face in order to improve patient care in our region.

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“…Although an increase in the number of rheumatologists and training programmes has been observed in recent years [64], global and regional shortfalls remain (especially for paediatric rheumatologists) as well as pronounced disparities between urban and rural areas [10,35,60,[64][65][66]. Factors contributing to this shortage are complex and multifaceted.…”

Section: Shortfalls In Rheumatologistsmentioning

confidence: 99%

A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education

et al. 2019

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Rheumatic and musculoskeletal diseases (RMDs) encompass a spectrum of degenerative, inflammatory conditions predominantly affecting the joints. They are a leading cause of disability worldwide and an enormous socioeconomic burden. However, worldwide deficiencies in adult and paediatric RMD knowledge among medical school graduates and primary care physicians (PCPs) persist. In October 2017, the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD), an international think tank of RMD and related experts, met to discuss key challenges and opportunities in undergraduate RMD education. Topics included needs analysis, curriculum content, interprofessional education, teaching and learning methods, implementation, assessment and course evaluation and professional formation/career development, which formed a framework for this white paper. We highlight a need for all medical graduates to attain a basic level of RMD knowledge and competency to enable them to confidently diagnose, treat/manage or refer patients. The importance of attracting more medical students to a career in rheumatology, and the indisputable value of integrated, multidisciplinary and multiprofessional care are also discussed. We conclude that RMD teaching for the future will need to address what is being taught, but also where, why and to whom, to ensure that healthcare providers deliver the best patient care possible in their local setting.

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Review of Current Workforce for Rheumatology in the Countries of the Americas 2012–2015

Cited by 29 publications

References 19 publications

The European network for care of children with paediatric rheumatic diseases: care across borders

The European network for care of children with paediatric rheumatic diseases: care across borders

Latin-American challenges and opportunities in rheumatology

A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education

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