2017 March AHPA Newsbrief
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Ontario AHPA members and ORA
ACPAC Application for 2017-18 Program
Upcoming Courses and Conferences
Recent Articles and Online Resources
Ontario AHPA Members are Invited to Attend the Ontario Rheumatology Association (ORA) Annual General Meeting
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
Upcoming Courses and Conferences
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)
Arthritis Society CPSIA 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
Secukinumab for Long-Term Treatment of Psoriatic Arthritis: A Two-Year Followup From a Phase III, Randomized, Double-Blind Placebo-Controlled Study
Kavanaugh, A., Mease, P. J., Reimold, A. M., Tahir, H., Rech, J., Hall, S., Geusens, P., Wang, Z., Pricop, L., Mpofu, S. and for the FUTURE-1 Study Group (2017), Secukinumab for Long-Term Treatment of Psoriatic Arthritis: A Two-Year Followup From a Phase III, Randomized, Double-Blind Placebo-Controlled Study. Arthritis Care Res, 69: 347–355. doi: 10.1002/acr.23111
To assess the 2-year efficacy and safety of the interleukin-17A inhibitor, secukinumab, in active psoriatic arthritis (PsA).
In the FUTURE-1 study, 606 patients with active PsA were randomized to secukinumab 10 mg/kg intravenously at baseline, and at weeks 2 and 4, followed by 150 mg or 75 mg subcutaneously (SC) every 4 weeks from week 8, or matching placebo. Patients receiving placebo were re-randomized to secukinumab 150 mg or 75 mg SC from week 16 or week 24, depending upon clinical response. Treatment continued to week 104. Exploratory analysis of all primary and secondary end points, on an intent-to-treat basis, continued to week 104.
A total of 476 patients (78.5%) completed 104 weeks of treatment. Secukinumab showed sustained efficacy across multiple domains of PsA through week 104, including signs and symptoms, disease activity, quality of life, physical function, skin symptoms, dactylitis, and enthesitis. American College of Rheumatology criteria for 20% improvement response rates were 66.8% with secukinumab 150 mg and 58.6% with secukinumab 75 mg at week 104; Psoriasis Area and Severity Index criteria for 75% improvement response rates were 74.6% and 63.0%, respectively (multiple imputed data). At week 104, 84.3% of patients in the secukinumab 150 mg group and 83.8% in the secukinumab 75 mg group showed no radiographic disease progression (observed data). No new or unexpected safety signals were reported during 2 years of treatment. Immunogenicity to secukinumab was low.
Secukinumab provided sustained improvements in PsA at 2 years, with very little radiographic progression. Treatment was well tolerated over the long term.
Direct and Indirect Determinants of the Patient Global Assessment in Rheumatoid Arthritis: Differences by Level of Disease Activity
Ward, M. M., Guthrie, L. C. and Dasgupta, A. (2017), Direct and Indirect Determinants of the Patient Global Assessment in Rheumatoid Arthritis: Differences by Level of Disease Activity. Arthritis Care Res, 69: 323–329. doi: 10.1002/acr.22953
In rheumatoid arthritis (RA), the patient global assessment (PGA) has been strongly associated with pain severity, but less often with other measures, including disease activity measures. We tested whether RA activity and psychological measures had direct associations with the PGA or indirect associations that were mediated by pain. We also tested whether the correlates of the PGA differed with the degree of RA activity.
We studied 260 patients with active RA on 2 visits in a prospective longitudinal study. We used path analysis to test direct and indirect associations of Disease Activity Score in 28 joints (DAS28), morning stiffness, Health Assessment Questionnaire (HAQ), fatigue, physical role limitations, social functioning, depressive symptoms, and health distress with the PGA.
Among the 509 visits, the median PGA score was 50 (25th–75th percentile: 24–66). Pain severity had the strongest association with the PGA, but direct associations were also found for morning stiffness severity, health distress, fatigue, and DAS28. Morning stiffness severity, DAS28, health distress, and HAQ were also indirectly associated with the PGA through pain. Among visits with DAS28 ≥5.4, pain, morning stiffness severity, and HAQ were the only determinants of the PGA. Among visits with DAS28 <4.2, health distress and age were additional determinants, and fatigue was marginally associated with the PGA.
Although pain was the strongest determinant of the PGA in RA, morning stiffness severity, health distress, fatigue, and DAS28 were also important. Determinants of the PGA differed with RA activity, with health distress, age, and to a lesser degree, fatigue, contributing only in patients with less active RA.
Next News Brief Deadline
The deadline for the April newsletter will be March 31th 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.