HealthDay News – Nurse practitioners and physician assistants can help reduce shortages in rheumatology workforce, according to research published in Arthritis Care & Research.

After surveying NPs and PAs during 2012 regarding level of practice independence, responsibilities, drug prescribing, use of objective outcome measures, and knowledge and use of treat-to-target (TTT) strategies, Daniel H. Solomon, MD, MPH, of Brigham and Women’s Hospital in Boston, and colleagues found that clinicians in both professions operate with a high level of independence and broad responsibilities in rheumatology practice.

Among 174 respondents (mean age 46 years; 83% female), three-quarters had ≤10 years of experience and 53% received formal training in rheumatology. Almost two-thirds reported having their own panel of patients.

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Performing patient education, adjusting medication doses, and conducting physical examinations were the top three practice responsibilities for nearly all respondents. The majority (>90%) felt very or somewhat comfortable diagnosing rheumatoid arthritis and had prescribed disease-modifying antirheumatic drugs.

Although three-quarters reported using disease activity measures for rheumatoid arthritis, just over half (56%) reported that their practices used TTT strategies.

“These data suggest midlevel providers may help to reduce shortages in the rheumatology workforce and conform with recommendations to employ TTT strategies in RA treatment,” wrote the authors.


  1. Solomon D et al. Arthritis Care & Research. 2014; doi: 10.1002/acr.22255

Disclosures: One author disclosed financial ties to the pharmaceutical industry