Browsing by Author "Ferreira, Ricardo J.O."
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- Assessment of rehabilitation nurses' knowledge and results of nurse educational programme (C2F) regarding osteoporosis and fragility fracturesPublication . Pimentel, Georgina; Cruz, Arménio; Baixinho, Cristina Lavareda; Loureiro, Maria; Fernandes, Silvia; Ferreira, Ricardo J.O.; Marques, AndréaBackground: Providing adequate care for the person with a fragility fracture is essential to prevent recurrences. A key strategy involves training by improving nursing care in the fields of osteoporosis and fragility fractures. However, in Portugal, there is no report on the level of knowledge of nurses, nor experimental studies on how to improve it. Objective: The study aimed to assess the knowledge of Rehabilitation Nurses in Portugal on osteoporosis and fragility fractures. Additionally, it sought to evaluate the impact of a specific educational programme on nurses' knowledge. Methods: In Phase I, a cross-sectional study involved 452 participants, utilizing a 26-question knowledge test. In Phase II, a quasi-experimental study included 42 nurses from 28 hospitals, subjected to a 30-h hybrid educational programme. The program comprised 9 online (2 h 30 min each) and 2 live sessions, covering assessment, pharmacological and non-pharmacological treatment, monitoring, project planning, consultations, and outcome indicators measurement. A before-and-after programme knowledge test was administered. Results: Phase I revealed an average knowledge score of 69.6%. In Phase II, there was a significant improvement with programme (70.4% vs. 85.8%, p < 0.01). Specialized nurses performed better than non-specialized nurses (80% vs. 75%, p = 0.011), and those from orthopaedic services showed the greatest improvement (92% vs. 83%, p = 0.014). Conclusions: Rehabilitation Nurses in Portugal have room to improve their knowledge of osteoporosis and fragility fractures. The hybrid educational programme proved effective in improving nurses' knowledge, especially among specialist and orthopaedic service nurses. We hope that this knowledge can be translated into continuous improvement in healthcare provision.
- EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 updatePublication . Gossec, Laure; Kerschbaumer, Andreas; Ferreira, Ricardo J.O.; Aletha, Daniel; Baraliakos, Xenofon; Bertheussen, Heidi; Boehncke, Wolf-Henning; Esbensen, Bente Appel; McInnes, Iain B; McGonagle, Dennis; Winthrop, Kevin L; Balanescu, Andra; Balint, Peter V; Burmester, Gerd R; Cañete, Juan D; Claudepierre, Pascal; Eder, Lihi; Hetland, Merete Lund; Lagnocco, Annamaria; Kristensen, Lars Erik; Lories, Rik; Queiro, Rubén; Mauro, Daniele; Marzo-Ortega, Helena; Mease, Philip J; Nash, Peter; Wagenaar, Wendy; Savage, Laura; Schett, Georg; Shoop-Worrall, Stephanie J W; Tanaka, Yoshiya; Van den Bosch, Filip E; van der Helm-van Mil, Annette; Zabotti, Alen; van der Heijde, Désirée; Smolen, Josef SObjective: New modes of action and more data on the efficacy and safety of existing drugs in psoriatic arthritis (PsA) required an update of the EULAR 2019 recommendations for the pharmacological treatment of PsA. Methods: Following EULAR standardised operating procedures, the process included a systematic literature review and a consensus meeting of 36 international experts in April 2023. Levels of evidence and grades of recommendations were determined. Results: The updated recommendations comprise 7 overarching principles and 11 recommendations, and provide a treatment strategy for pharmacological therapies. Non-steroidal anti-inflammatory drugs should be used in monotherapy only for mild PsA and in the short term; oral glucocorticoids are not recommended. In patients with peripheral arthritis, rapid initiation of conventional synthetic disease-modifying antirheumatic drugs is recommended and methotrexate preferred. If the treatment target is not achieved with this strategy, a biological disease-modifying antirheumatic drug (bDMARD) should be initiated, without preference among modes of action. Relevant skin psoriasis should orient towards bDMARDs targeting interleukin (IL)-23p40, IL-23p19, IL-17A and IL-17A/F inhibitors. In case of predominant axial or entheseal disease, an algorithm is also proposed. Use of Janus kinase inhibitors is proposed primarily after bDMARD failure, taking relevant risk factors into account, or in case bDMARDs are not an appropriate choice. Inflammatory bowel disease and uveitis, if present, should influence drug choices, with monoclonal tumour necrosis factor inhibitors proposed. Drug switches and tapering in sustained remission are also addressed. Conclusion: These updated recommendations integrate all currently available drugs in a practical and progressive approach, which will be helpful in the pharmacological management of PsA.
- Letter to the Editor: Best Practices on Public and Patient Involvement in Interprofessional Healthcare EducationPublication . Ferreira, Ricardo J.O.; Leal, Matilde; Mateus, Elsa Frazão; Gosak, Lucija; Matthijs H. Bosveld; Kline, Cathy C.; PULPIT Consortium
- Remission versus low disease activity as treatment targets in rheumatoid arthritis: how to strike the right balance between too strict and too lenient targets? A meta-epidemiological study of individual patient dataPublication . Duarte, Cátia; Jacobs, Johannes W.G.; Ferreira, Ricardo J.O.; Welsing, Paco M.J.; Gossec, Laure; Machado, Pedro M.; van der Heijde, Désirée; Silva, José António Pereira daObjectives: To evaluate the impact of using Simplified Disease Activity Index (SDAI)-LDA (low disease activity) versus different definitions of remission as a treatment target in established rheumatoid arthritis. Methods: A meta-epidemiological study of individual patient data from eight randomised controlled trials was performed. Four definitions of the target were considered at 6 months: (1) SDAI-LDA: SDAI≤11; (2) SDAI-Remission: SDAI≤3.3; (3) 4V-Remission: Tender and swollen 28-joint counts and C reactive protein (mg/dL) all ≤1 and patient global assessment (PGA)≤2 and (4) 3-variable (3V)-Remission: as 4V, excluding PGA. The mean radiographic change in the modified total Sharp-van der Heijde score (mTSS) and the Good Radiographic Outcome rates (defined as a change of ≤0.5 units mTSS) over 2 years were compared among target definitions. Radiographic progression and the distribution of the individual criteria of the Boolean definition in the only LDA subgroup (3.32, reflecting relevant disease impact. Conclusion: SDAI-LDA is associated with more structural damage over 2 years than any of the definitions of remission. It also allows substantial disease impact to go unchecked and uncontrolled. Physicians should strive for remission whenever possible and safe while also taking into account the different individual disease activity parameters included in the adopted definition.