2017 February AHPA Newsbrief
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AHPA Board of Directors
ORA Educational Grant
ACPAC Application for 2017-18 Program
Upcoming Courses and Conferences
Recent Articles and Online Resources
INTERESTED IN BECOMING AN AHPA BOARD DIRECTOR?
The AHPA Board is a dynamic group of individuals, with national representation, all with a common interest in care provision, education, and research related to arthritis.
We are currently accepting nominations for 4 positions on the AHPA Board of Directors. Elections will be held at the AHPA Annual General Meeting in Ottawa, Ontario on February 10, 2017 during the 2017 Annual CRA Scientific Meeting and AHPA Annual Meeting.
We are seeking individuals with an interest in the following Board responsibilities:
President-Elect, Member at Large Western, Membership Committee Chair, and Communications Committee Chair.
If you are interested, please refer to the AHPA Website for further details.
Please complete the nomination form and email the required documents to the Member at Large Eastern Canada, Lynne Broderick, at Lynne.Broderick@hotmail.com
The Ninth Annual AHPA Pre-course will be held at the Canadian Rheumatology Association/Arthritis Health Professions Association annual meeting on Wednesday, February 8, 2017 at the Westin Hotel, Ottawa.
Please note that any member with dietary restrictions or needs should send a detailed email to Angelo Papachristos : firstname.lastname@example.org
ORA Educational Grant
The mandate of the Ontario Rheumatology Association Development and Education Committee (ORADE) is to support ORA members and AHP colleagues in their professional development by offering educational grants. In the past, ORADE grants were restricted to participation at either EULAR or ACR, and candidates were required to select conference material that was relevant to the ORA pillars. After careful consideration, the ORADE Committee has decided to change the guidelines for 2017. Educational grants will now be available to ORA members and licensed AHPs working in a rheumatology setting to attend ANY international scientific rheumatology meeting or course. Here is how the grants will be allocated:
ACPAC Application for 2017-18 program
The Advanced Clinician Practitioner in Arthritis Care (ACPAC) program is pleased to announce that applications for its 2017-2018 program are NOW OPEN. ACPAC is a hybrid academic and clinical training program that prepares experienced physical therapists, occupational therapists, and nurses for extended practice roles in the diagnosis and management of patients with arthritis. Fellowships are available for this year’s program. The deadline to apply is Friday May 19, 2017. For more information contact Julia Ferrari (email@example.com) or to apply visit our new website at www.acpacprogram.ca.
2017-2018 ACPAC Program Weeks
Week 1 - October 23-28, 2017 (Includes the conference “13th Annual Arthritis Day” Saturday October 28, 2017)
Week 2 - December 11-15, 2017
Week 3 - February 5-9, 2018
Week 4 - April 9-13, 2018
Week 5 - June 4-8, 2018
Upcoming Courses and Conferences
Date: February 8th 2017
Location: Ottawa, Ontario
For more information: www.ahpa.ca
Canadian Rheumatology Association Annual Scientific Meeting
Date: February 8-11th 2017
Location: Ottawa, Ontario
For more information and to register: www.rheum.ca
Assessment and Management of Rheumatic Diseases is a 4-day skills workshop for physical therapists, occupational therapists and nurses.
Date: April 3 – 6, 2017
Location: Mary Pack Arthritis Centre, Vancouver, British Columbia
Cost: $656.25 ($625 + $31.25 GST)
Key benefits of attending:
* Update your knowledge of evidence-based care for three common forms of arthritis
* Practice hands-on assessment skills with patient models
* Learn from multidisciplinary instructors and case studies
* Registration deadline is March 3, 2017
For more information and a copy of the workshop brochure visit http://mpap.vch.ca/resources-for-professionals/becoming-an-ace-member or contact firstname.lastname@example.org (mailto:email@example.com)
Beyond the Break
Part 2: Importance of Exercise, Strength Training, Balance and Posture Training for Fall Prevention – Clinical Application
Date: February 16, 2017 | Time: 1:00 pm – 2:00 pm EST| TSM#: 65015800
Maureen Ashe, PhD
Dolores Langford, PT?Centre for Hip Health and Mobility
University of British Columbia
To register for this event visit:
Arthritis Society Clinical Practice Skills for Inflammatory Arthritis Program
Date: May 3-6, 2017
Event Location: Hampton Inn & Suites by Hilton Toronto Airport, Ontario, Canada.
The program progressively develops the participants’ clinical practice skills over a 4-day period through a blend of online, didactic, interactive and experiential learning on the most prevalent arthritis conditions. Participants who complete all of the program requirements receive a Certificate of Program Completion issued by The Arthritis Society.
The CPSIA is suitable for a wide range of professionals who provide client-centred healthcare to people with arthritis across a continuum of settings and stage of disease. (The program does not address childhood arthritis). Graduates include Physiotherapists, Occupational Therapists, Registered Nurses and Nurse Practitioners, many of whom have successfully completed the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program.
The program emphasizes best practice assessment and management techniques as applied to the most common types of inflammatory arthritis.
Upon completion of the program, the participant will have the skills to effectively recognize and report on the health status of clients with inflammatory and osteoarthritis and to formulate an appropriate management plan.
Bone Fit Workshops - Osteoporosis Canada
Date: March 18th 2017
Location: Renfrew, ON
This evidence-informed exercise training workshop is designed for healthcare professionals & exercise practitioners to provide training on the most appropriate, safe & effective methods to prescribe & progress exercise for people with osteoporosis.
Recent Articles and Online Resources
Interaction Between Low-Dose Methotrexate and Nonsteroidal Anti-inflammatory Drugs, Penicillins, and Proton Pump Inhibitors.Hall JJ, Bolina M, Chatterley T, Jamali F. Ann Pharmacother. 2017 Feb;51(2):163-178. doi: 10.1177/1060028016672035. Epub 2016 Oct 4.
To review the potential drug interactions between low-dose methotrexate (LD-MTX) and nonsteroidal anti-inflammatory drugs (NSAIDs), penicillins, and proton-pump inhibitors (PPIs) given the disparity between interactions reported for high-dose and low-dose MTX to help guide clinicians.
A literature search was performed in MEDLINE (1946 to September 2016), EMBASE (1974 to September 2016), and International Pharmaceutical Abstracts (1970 to January 2015) to identify reports describing potential drug interactions between LD-MTX and NSAIDS, penicillins, or PPIs. Reference lists of included articles were reviewed to find additional eligible articles.
Study Selection and Data Extraction
All English-language observational, randomized, and pharmacokinetic (PK) studies assessing LD-MTX interactions in humans were analyzed to determine clinical relevance in making recommendations to clinicians. Clinical case reports were assigned a Drug Interaction Probability Scale score.
A total of 32 articles were included (28 with NSAIDs, 3 with penicillins, and 2 with PPIs [1 including both PPI and NSAID]). Although there are some PK data to describe increased LD-MTX concentrations when NSAIDs are used concomitantly, the clinical relevance remains unclear. Based on the limited data on LD-MTX with penicillins and PPIs, no clinically meaningful interaction was identified.
Given the available evidence, the clinical importance of the interaction between LD-MTX and NSAIDs, penicillins, and PPIs cannot be substantiated. Health care providers should assess the benefit and risk of LD-MTX regardless of concomitant drug use, including factors known to predispose patients to MTX toxicity, and continue to monitor clinical and laboratory parameters per guideline recommendations.
Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis
Liu, Y., Hazlewood, G. S., Kaplan, G. G., Eksteen, B. and Barnabe, C. (2017), Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Arthritis Care Res, 69: 157–165. doi: 10.1002/acr.22932
To summarize the relationship between obesity and remission in rheumatoid arthritis (RA); secondary objectives were to summarize other measures of treatment response and mortality in RA.
Medline and Embase searches were performed in March 2016 using relevant MeSH and keyword terms for obesity and RA. Articles were selected if they reported estimates for achieving remission in obese subjects relative to other body mass index (BMI) categories, or changes in composite or individual disease activity measures or patient-reported outcomes during therapy, or mortality rates, in relation to BMI category or on a continuous scale. Remission outcomes were conducive to meta-analysis, and all other outcomes were summarized.
A total of 3,368 records were screened; we included 8 reporting remission rates, 9 reporting disease activity measures or patient-reported outcomes, and 3 examining mortality by obesity status or BMI. Obese patients attain remission less frequently than nonobese and/or normal-weight patients. In adjusted models, obese patients demonstrated lower odds of achieving remission (pooled odds ratio [OR] 0.57 [95% confidence interval (95% CI) 0.45, 0.72]) and sustained remission (pooled OR 0.49 [95% CI 0.32, 0.74]) relative to nonobese subjects. Most studies found obese patients to have worse Disease Activity Scores or Disease Activity Scores in 28 joints, tender joint counts, inflammatory markers, patient global evaluation scores, pain scores, and physical function scores during followup, but not worse swollen joint counts. Obesity was not associated with increased mortality.
Obesity decreases the odds of achieving remission in RA and negatively impacts disease activity and patient-reported outcomes during therapy. Interventions to reduce BMI should be investigated for their ability to improve disease outcomes.
Is There an Association Between a History of Running and Symptomatic Knee Osteoarthritis? A Cross-Sectional Study From the Osteoarthritis Initiative
Lo, G. H., Driban, J. B., Kriska, A. M., McAlindon, T. E., Souza, R. B., Petersen, N. J., Storti, K. L., Eaton, C. B., Hochberg, M. C., Jackson, R. D., Kent Kwoh, C., Nevitt, M. C. and Suarez-Almazor, M. E. (2017), Is There an Association Between a History of Running and Symptomatic Knee Osteoarthritis? A Cross-Sectional Study From the Osteoarthritis Initiative. Arthritis Care Res, 69: 183–191. doi: 10.1002/acr.22939
Regular physical activity, including running, is recommended based on known cardiovascular and mortality benefits. However, controversy exists regarding whether running can be harmful to knees. The purpose of this study is to evaluate the relationship of running with knee pain, radiographic osteoarthritis (OA), and symptomatic OA.
This was a retrospective cross-sectional study of Osteoarthritis Initiative participants (2004–2014) with knee radiograph readings, symptom assessments, and completed lifetime physical activity surveys. Using logistic regression, we evaluated the association of history of leisure running with the outcomes of frequent knee pain, radiographic OA, and symptomatic OA. Symptomatic OA required at least 1 knee with both radiographic OA and pain.
Of 2,637 participants, 55.8% were female, the mean ± SD age was 64.3 ± 8.9 years, and the mean ± SD body mass index was 28.5 ± 4.9 kg/m2; 29.5% of these participants ran at some time in their lives. Unadjusted odds ratios of pain, radiographic OA, and symptomatic OA for those prior runners and current runners compared to those who never ran were 0.83 and 0.71 (P for trend = 0.002), 0.83 and 0.78 (P for trend = 0.01), and 0.81 and 0.64 (P for trend = 0.0006), respectively. Adjusted models were similar, except radiographic OA results were attenuated.
There is no increased risk of symptomatic knee OA among self-selected runners compared with nonrunners in a cohort recruited from the community. In those without OA, running does not appear to be detrimental to the knees.
Next News Brief Deadline
The deadline for the March newsletter will be February 28th 2017. Please send any contributions to Julia Farquharson at Julia.firstname.lastname@example.org. We are particularly interested in notices of conferences or workshops, new resources for patients or health professionals and summaries of recent research/publications. We welcome contributions from members from all parts of the country.