Putting patients first: the need for evidence-based and patient-centered standards of care in rheumatoid arthritis

Abstract

All over the world, musculoskeletal diseases have major individual, societal and economic implications [1]. Musculoskeletal diseases require the attention of several medical disciplines such as rheumatology and rehabilitation, including both physicians and nonphysician health professionals. However, it is not only these ‘specialists’, but also the patients themselves play an important role in musculoskeletal care. Apart from shared goal setting, for example, when a new medication is prescribed, patients need to be actively involved in rehabilitation care: a considerable number of interventions such as appropriate pain management, activity pacing, enhancing physical activity, maintaining a range of activities, performing activities in a joint protective way, using assistive devices, and so fourth, will not be successful if they are not administered in a patient-centered and patient actively involving way. Furthermore, there is initial qualitative evidence that people who are more actively involved in decisions about their musculo skeletal disease may have a better health outcome [2]. Involvement of patients is thus a crucial issue in rheumatology and rehabilitation. Patients should not only participate in their own care, but can – if interested – take on different roles in research projects. Patients can contribute essential parts in qualitative research in that they report about their experiences in daily life (and thus allow researchers, specialists and experts to share their views), but can also take on even more ‘equal’ expert roles such as being a ‘patient research partner’ in the advisory boards of all kinds of research projects or become scientific authors themselves [3]. Qualitative action research claims that the active involvement of all stakeholders in a certain research project is essential [4]. However, this is still rather uncommon in many countries such as Austria. Austria