Is There an NP in the Rheum? The Role of Nurse Practitioners in Overcoming Underrecognition and Treatment Delays to Improve Patient Outcomes in Axial Spondyloarthritis

Target Audience

This educational initiative is designed for nurse practitioners, advance practice nurses, physicians, and physician assistants who work in primary care and manage patients with axial spondyloarthritis.

Program Overview

Axial spondyloarthritis (axSpA) is a chronic, relapsing/remitting inflammatory rheumatic disease that causes low back pain. Most patients develop axSpA in the prime of their lives with 20 to 30 years old being the most common age of onset. Unfortunately, patients with axSpA wait, on average, 5 to 7 years before being diagnosed, with evidence suggesting women wait significantly longer than men. Diagnostic delay and lack of treatment can lead to spinal and sacroiliac joint fusion, abnormal formation of new bone, and disability. This problem is exacerbated by the growing shortage of rheumatologic providers.

One way to offset this imbalance is the training of nurse practitioners (NPs) and physician assistants (PAs) in rheumatology. These advanced practice providers can achieve high levels of independence and clinical expertise in the management of rheumatic diseases, with responsibilities ranging from early diagnosis and clinical workups to prescribing medications. In this program, NPs and PAs will learn to differentiate inflammatory from noninflammatory pain, evaluate the response to therapy, and make treatment recommendations in axSpA, with the ultimate goals of improving patients’ access to rheumatology services and their quality of care.

Learning Objectives

Upon completion of this activity, participants should be better able to:

Outline methods for differentiating between mechanical and inflammatory back pain using ASAS classification criteria for axSpA, based on clinical presentation, laboratory studies, and appropriate imaging
Explain how axSpA manifests differently in women in order to facilitate a timelier diagnosis and avoid worsening symptoms
Discuss how to manage the extra-articular manifestations and quality-of-life concerns that are common in patients with axSpA
List the guideline recommendations and clinical trial evidence for to the management of axSpA