REAL-PANLAR Project for the Implementation and Accreditation of Centers of Excellence in Rheumatoid Arthritis Throughout Latin America

摘要: The mission of PANLAR (Pan American League Associations for Rheumatology) is 2-fold: (1) to stimulate and promote the study research rheumatic diseases prevention, treatment, rehabilitation patients with conditions in continent (2) continuing development specialty rheumatology. committed encourage facilitate patient access care as it affects ability disease obtain affordable, high-quality, specialized health care. The national systems within Latin America (LA) Caribbean area are heterogeneous their organizational structure complex operational configuration principles guiding public private sector roles provision services. countries exhibit wide variations regarding main objectives operation. Chronic illnesses, which greatly impact quality life, actually 1 priorities despite requiring efforts manage burden infectious diseases, providing reproductive-age female population, childhood pathology, violence-related injuries, among others.1 Patients rheumatoid arthritis (RA) have substantial unmet medical needs. World Health Organization recommends at least rheumatologist per 100,000 people, that is, an estimated need 6000 specialists LA. Currently excluding United States Canada, 19 LA Rheumatology National Societies a workforce around 3900 serve 588 million inhabitants. Not all rheumatologists active, nor they accredited according country requirements.2 Although this number could be higher because some active practicing not affiliated local societies, therefore, actual cannot determined accurately. In addition shortage countries, regional distribution on supply mainly metropolitan areas, whereas other areas low density specialists, such rural small towns, resulting several underserved areas. These factors only constitute barriers care, but also contribute suboptimal provided, poor diagnosis, treatment RA large proportion affected individuals.3,4 However problem face. Most region limited medicines, programs, orthopedic interventions, highly recommended optimal management. Moreover, do education necessary empower them families daily management adjustment drug therapy alone does substantially improve life.3,4 data reveal importance considering early diagnosis adequate priority has shown effectively reduce disability long run.3,4 Accurate measures known indicators (QIs) needed assess care. Quality usually more specific compared recommendation guidelines, precisely describe who must what, whom, exactly when.5 2007, College (ACR) submitted set minimum QIs care; adherence these standards seems possible. Introduction presents clinicians enormous opportunity clearly understand expected profession.6 An essential goal establishing should delivered means evaluate across provider groups improvement ultimately lead better outcomes.6 The involvement scientific organizations important way delivering message implementing RA. Eventually, may feasible move beyond specification minimal reach consensus good excellent our patients. There great potential growing member societies through evidence-based interventions harmonization REAL (Red de Excelencia en Artritis para la Latina) project evolved strategic implement Centers Excellence (CoEs) throughout help ensure patients, improving life managing costs. Taking into account difficulties posed by diverse system lack resources, goals follows: To assessment alignment clinical guidelines Treat Target (T2T) strategy7 To accomplish measure document activity, disability, comorbidities, patients To establish harmonized inform doctors allied professionals about aspects RA To educate family members facts order cope collaborate, programs To accessibility centers continuous foster registries databases To form alliance governments nongovernmental T2T strategy CoEs region To raise awareness policy makers, payers, insurers