JIA

Call for more access to pediatric rheumatology teams


Better access to multidisciplinary teams would improve the standard of care for young patients with rheumatic diseases, a small survey of paediatric rheumatologists has found.

According to a letter in the Medical Journal of Australia, most respondents believed access to a physiotherapist, rheumatology nurse or occupational therapist would improve outcomes for their patients.

Author Dr Davinder Singh-Grewal, chair of the Australian Paediatric Rheumatology Group, said a more coordinated care approach would improve issues such as psychological wellbeing, adherence to medications and physical activity.

“We need a better mix of skills especially for our patients with complicated disease. Research shows a multidisciplinary team does make a difference to clinical outcomes and the patient experience,” he told the limbic in an interview.

Most survey respondents agreed that multidisciplinary team care was necessary but only half believed that it was easily available to their patients.

Not surprisingly, there was almost universal agreement that patients in regional areas had particular problems accessing this type of care close to home.

“We can improve on the limited outreach services by upskilling and supporting local clinicians such as adult rheumatologists willing to see these children or pediatricians,” Dr Singh-Grewal said.

However the survey also identified concerns about workforce issues including adequate training in childhood rheumatic diseases.

Dr Singh-Grewal said only two hospitals – the Royal Children’s Hospital in Melbourne and Princess Margaret Hospital in Perth – were accredited to train paediatric rheumatologists.

He said the resulting workforce shortage meant clinicians were ‘chasing their tails’ to provide an acceptable standard of care.

“This also impacts on our ability to educate other doctors, nurses and allied health professionals and to participate effectively in research.”

“We are a developed health economy and we are asking for our patients to be able to access international best practice. Currently in terms of access to paediatric rheumatology, we are 20 years behind countries like the UK, Canada and the US.”

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