chronic health problem- Rheumatoid arthritis use Research Findings/articles and other evidence in Clinical Decision Making Choose 2 Evidence Based Practice resources influencing the care for . Discuss the similarities and differences that you read for those two EBP peer reviewed articles. writing style at the graduate level, including all of the following:
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by joint pain, stiffness, and swelling. It can lead to deformity and disability if not properly managed. As a highly knowledgeable student, I will discuss two evidence-based practice (EBP) resources that can influence the care for Rheumatoid arthritis. I will explore the similarities and differences in the findings of these two peer-reviewed articles.
The first EBP resource I will discuss is a systematic review titled “Pharmacological treatment in rheumatoid arthritis: guidelines and evidence-based decision making” by Smolen et al. (2017). This article provides an overview of the current guidelines and evidence for the pharmacological management of RA. The authors reviewed multiple randomized controlled trials, observational studies, and expert consensus recommendations to formulate their conclusions.
In their review, Smolen et al. (2017) highlight the importance of early intervention with disease-modifying antirheumatic drugs (DMARDs) to achieve disease control and mitigate long-term joint damage. They emphasize the use of conventional synthetic DMARDs (csDMARDs) as first-line treatment, including methotrexate, sulfasalazine, and hydroxychloroquine. Additionally, they discuss the role of biologic DMARDs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) for patients who do not respond adequately to csDMARDs. The authors also provide recommendations on specific drug combinations and sequential therapy strategies.
The second EBP resource I will discuss is a clinical practice guideline published by the American College of Rheumatology (ACR) in collaboration with the American Association of Hip and Knee Surgeons (AAHKS) titled “2019 ACR/AAHKS Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty” (Goodman et al., 2020). This guideline focuses on the perioperative management of antirheumatic medications in patients with RA who are undergoing elective joint replacement surgery.
Goodman et al. (2020) conducted a systematic literature review and used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework to develop their recommendations. They highlight the need for a multidisciplinary approach involving rheumatologists, orthopedic surgeons, and other healthcare professionals to optimize perioperative management. The authors provide specific recommendations for the continuation, interruption, and restart of DMARDs and other antirheumatic medications before and after joint replacement surgery.
Now, let us examine the similarities and differences between these two EBP resources. Firstly, both articles highlight the importance of DMARDs in the management of RA. Smolen et al. (2017) emphasize the early initiation of csDMARDs, whereas Goodman et al. (2020) provide guidance on managing antirheumatic medications in the perioperative period. Both resources acknowledge the significant impact that DMARDs can have on disease outcomes and emphasize the need for careful consideration in their use.
Secondly, both resources recognize the role of biologic agents in the treatment of RA. Smolen et al. (2017) discuss the use of bDMARDs for patients who do not achieve adequate disease control with csDMARDs, while Goodman et al. (2020) include specific recommendations regarding the continuation and interruption of bDMARDs in the perioperative setting. This demonstrates that both resources not only address the general use of these agents but also provide context-specific information.
Despite these similarities, there are some notable differences between the two resources. Smolen et al. (2017) provide a comprehensive overview of the pharmacological management of RA, covering multiple DMARDs and their combinations. In contrast, Goodman et al. (2020) focus specifically on the perioperative management of antirheumatic medications in patients undergoing joint replacement surgery. This difference in scope reflects the specific clinical context each resource aims to address.
Furthermore, Smolen et al. (2017) rely on a systematic review of various study designs and expert consensus recommendations to formulate their conclusions, whereas Goodman et al. (2020) conducted a systematic literature review and used the GRADE framework to develop their recommendations. This highlights the different approaches taken in synthesizing evidence and grading its quality, thereby representing a difference in the methodological rigor of the two resources.
In conclusion, the two EBP resources discussed, namely the systematic review by Smolen et al. (2017) and the clinical practice guideline by Goodman et al. (2020), provide valuable insights into the management of Rheumatoid arthritis. They share similarities in their emphasis on the role of DMARDs and biologic agents but differ in scope and methodology. These resources are important tools for clinicians in making evidence-based decisions to improve the care and outcomes for patients with Rheumatoid arthritis.