The novel RA Extension for Community Healthcare Outcomes (ECHO) program, designed to train primary care physicians in diagnosing and treating Native American patients with rheumatoid arthritis, has expanded its reach, according to a press release from the ACR. Although rheumatoid arthritis is common among the Native American community, many patients in this population have limited or no access to rheumatologic care; consequently, these patients rely on primary care physicians who may not be confident in treating rheumatoid arthritis. Updates presented by Mandal et al at ACR Convergence 2023 offered insights into the expansion of the program from Navajo Nation primary care physicians to those serving Native American communities across the country. In partnership with Indian Country ECHO, the Rheumatology Access Expansion Initiative was able to recruit about 50 participants—including primary care physicians; pharmacists; community health representatives; and emergency medicine, ophthalmology, and orthopedic providers—to attend its 12-week RA ECHO program, which involved 30-minute interactive sessions on rheumatoid arthritis diagnosis and management followed by case-based discussions. After conducting medical knowledge tests and surveys following the training program, the researchers found that test scores increased by 26% and confidence levels increased by one point on a five-point scale between the first cohort and the fourth cohort. Additionally, about 80% of the participants reported performing significant clinical behaviors related to rheumatoid arthritis more frequently than they did prior to partaking in the program. The researchers concluded that in order to further improve their program, they plan to create culturally and linguistically tailored patient education materials, host in-person training for community health representatives, develop online resources for physicians, and establish a new RA ECHO training initiative in spondyloarthritis.
November 22, 2023