The global challenges and opportunities in the practice of rheumatology: White paper by the World Forum on Rheumatic and Musculoskeletal Diseases

Abstract

Rheumatic and musculoskeletal diseases (RMDs) represent a multitude of degenerative, inflammatory and auto-immune conditions affecting millions of people worldwide. Persons with these diseases may potentially experience severe chronic pain, joint damage, increasing disability and even death. With an increasingly ageing population, the prevalence and burden of RMDs are predicted to increase, placing greater demands on the global practice of rheumatology and related healthcare budgets. Effective treatment of RMDs currently faces a number of challenges in both the developed and developing world, and individual countries may face more specific local challenges. However, limited understanding of the burden of RMDs amongst public health professionals and policy-makers means that these diseases are often not considered a public health priority. The objective of this review is to increase awareness of the RMDs and to identify opportunities to address RMD challenges on both a local and global scale. On 26 September 2014, rheumatology experts from five different continents met at the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD) to discuss and identify some key challenges for the RMDs community today. The outcomes are presented in this review, focusing on access to rheumatology services, diagnostics and therapies, rheumatology education and training and on clinical trials, as well as investigator-initiated and epidemiological research. The long-term vision of the WFRMD is to increase perception of the RMDs as a major burden to society and to explore potential opportunities to improve global and local RMD care.Electronic supplementary materialThe online version of this article (doi:10.1007/s10067-014-2841-6) contains supplementary material, which is available to authorized users.

Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data

“…40 Our findings underline the need to increase awareness among patients, physicians and policy-makers of the major burden that rheumatic diseases places on patients, society and health care systems, and to prioritize planning of health care services, medical education 41,42 and research. 6 The relative shortage of rheumatologists, [43][44][45] especially in rural areas, and the projected increasing burden of rheumatic diseases 1,5 suggest a need for innovative models of care. 46,47 Rheumatology referrals often are not done in a standardized or consistent way, Note: IQR = interquartile range, NR = not reportable.…”

“…1,2 Optimal care for many rheumatic diseases hinges on early access to rheumatologists, but there are many hurdles that can impede optimal care, such as delays in patient presentation and physician referrals. 3 Given the growing burden and overall impact of rheumatic diseases, [4][5][6] providing patients with timely access to health care remains a panCanadian challenge that will only intensify over time.…”

Overcoming challenges in order to improve the management of rheumatic and musculoskeletal diseases across the globe

“…The Bone and Joint Decade has responded by bringing together all stakeholders-professional, scientific and patient organisations as a Global Alliance for Musculoskeletal Health calling for action by decision makers to implement policies to deal with this burden (http://bjdonline.org/call-for-action/). The specific challenges and opportunities for the rheumatology community have been considered by the inaugural meeting of the World Forum on Rheumatic and Musculoskeletal Diseases on the 26th of September in Abu Dhabi and are reported in this issue [1]. Subsequent papers are planned to address issues raised in the White Paper.…”

“…The nature of these challenges are considered in the White Paper, and the need to increase access to paediatric and adult rheumatologists identified as of high importance and a major challenge highlighted by Al Maini and colleagues [1]. Many parts of the world are devoid of rheumatologists.…”

“…The challenges faced in improving the prevention and management of rheumatic and musculoskeletal diseases (RMDs) across the globe are addressed in the inaugural White Paper from the World Forum on Rheumatic amd Musculoskeletal Diseases (WFRMD) published in this issue [1]. The WFRMD, convened by Dr Mustafa Al Maini, brings together leaders from the international rheumatological community who are committed to promoting collaborative strategies to deal with this burden and work with major organisations such as ILAR, ACR, EULAR, PANLAR and AFLAR and policy makers such as the World Health Organisation (WHO).…”