Rheumatology in the Middle East in 2017: clinical challenges and research

Abstract

The World Health Organization (WHO) has ranked musculoskeletal diseases among the top ten leading causes of disability in the Middle East. The situation in the Middle East is unique as, although seventeen countries are geographical connected, there is considerable variability in the standard of rheumatology care and research between the countries. There are several factors contributing to this variability: allocated government resources to healthcare services, country demographics, the implemented healthcare system, the number of qualified rheumatologist, political stability, and the immigration to and from these countries.

Biosimilars in rheumatology: recommendations for regulation and use in Middle Eastern countries

“…On the other hand, the quality of healthcare provision, particularly in the field of rheumatology, varies across the region due to differences in allocated government resources, patient demographics, the number of qualified rheumatologists, political stability, and population movements [ 3 ]. In some regions of the Middle East, patients cannot access the care they require [ 1 ].…”

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

“…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.…”

“…While some RMDs can be managed in primary care, the management of more complicated, multi-system, progressive diseases (or complex examples of common conditions) requires specialist expertise [24]. The global shortfall in rheumatologists alongside the increasing burden of RMDs highlights the urgent need to attract more medical students to a career in rheumatology [66]. Increasing exposure of medical students to RMDs early on is key.…”

Disease burden and treatment challenges of psoriatic arthritis in Africa and the Middle East

“…There is also a need for specific guidelines to be developed for the management of PsA in Africa and the Middle East, as the current published guidelines are primarily focused on the United States and Europe. Two recent editorials detail multiple obstacles faced by rheumatologists practicing in Africa and the Middle East, including a lack of disease awareness among both patients and healthcare professionals, drug accessibility, inadequate health funding, and a lack of rheumatologists [27,52]. While these obstacles are applicable to the management of PsA, treatment is further complicated by the requirement for both a rheumatologist and a dermatologist to provide care to patients and by the presence of multiple clinical domains, each of which may require a different therapy [2].…”

“…The role of specialist nurses is to help patients understand their treatment, assist clinicians, and aid communication between the multidisciplinary team [55], which in addition to rheumatologists and dermatologists may include a physiotherapist, a dietician, a psychologist, and a social worker. However, access to such resources is not widespread in Africa and the Middle East and is dependent on the healthcare service available in each country [52]. The logistics of running a multidisciplinary clinic within an outpatient clinic setting and the limited availability of interested dermatologists, specialist nurses, and clinic coordinators are limiting factors (author opinion).…”