title: Potential advantages of interprofessional care in rheumatoid arthritis.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) affects over 1 million people in the United States. Although the emergence of new medications has substantially improved treatment options and outcomes for patients with RA, the disease is still a major cause of morbidity and mortality. In addition, significant barriers to adherence characterize RA medication management. A reasonable approach to improving RA patient outcomes entails interprofessional, multidisciplinary models of care. Working with rheumatology specialists, RA multidisciplinary care teams may comprise case managers, pharmacists, physical and occupational therapists, social workers, physiatrists, orthopedists, or other health professionals. Experience and evidence have supported the value of interprofessional, coordinated care models for patients with various chronic diseases. However, potential drawbacks include the costs associated with implementation of such approaches, the extra time required for their administration, and the lack of incentives for clinicians to adopt collaborative care approaches.
  
  
  OBJECTIVE
  To summarize the arguments and evidence for interprofessional, multidisciplinary care programs in RA.
  
  
  CONCLUSIONS
  Various multidisciplinary models of RA care have been described in the literature. Whereas the case for implementing such models is underscored by the chronic nature of the disease, by its comorbidities and complications, and by barriers to patient medication adherence, cost-effectiveness analyses to document benefits of coordinated interprofessional RA care are lacking. Most studies on interprofessional care in RA are relatively old and have been conducted outside of the United States. Nonetheless, the findings are still relevant and may shed light on potential avenues for the development of new models in this country.
authors.affiliation: Health Services at Physicians Health Plan of Northern Indiana inFort Wayne, Indiana 46804, USA. cmarion@phpni.com
authors.forename: Carrie Engen
authors.initials: CE
authors.lastname: Marion
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Balfe
mesh_terms: D001172:Arthritis, Rheumatoid / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration* / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data