1. Shared Care Panel Discussion Caring for your Patient with Arthritis

2. 2  Moderator: Dr. Julia Alleyne  Dr. Diane Lacaille  Dr. Ken Hughes  Ms. Linda Li  Dr. George Watson  Dr. Patrick Chan Panelists

3. 3  Provide the panel with a rolling case  Direct questions to panel  Ask the panel to limit answers to 2 minutes  Ask audience for questions and comments  Closing pearls of practice Format

4. 4  Maggie is 51 years old and was diagnosed with Rheumatoid arthritis 7 years ago.  She has been managed with medications (Plaquenil) for inflammation but is still complaining of pain and swelling. Maggie’s Voice

5. 5 1. Where would you start in assessing Maggie’s symptoms and effectiveness of medication? 2. What is your approach to patient education regarding symptom management? Panelists

6. 6  Maggie works in a sedentary job and lives alone.  She is experiencing prolonged morning stiffness, night time pain and increased foot joint swelling. Maggie

7. 7 3. Would rehabilitation help Maggie cope better with work or home activities? 4. What has been your experience with community resources for patients like Maggie? Panelists

8. 8  2 weeks ago, Maggie started a walking program on the treadmill as she read that it exercise might help her. She started to run one day but felt a sudden pop in her knee and it has been swollen ever since. Maggie

9. 9 5. How do you assess knee pain which may be mechanical or osteoarthritic in the patient with inflammatory symptoms? 6. What is your criteria for surgical intervention in a patient with rheumatoid arthritis? Panelist

10. 10 What’s the scoop?  Who  When  Why  How Many Cortisone Injections

11. 11 “My biggest concern is that I won’t be able to support myself and I don’t know how to change things around this time. Being sick costs money! Life’s demands don’t stop just because you have arthritis.” Maggie  Maggie is divorced and has one sister who lives 3 hours away. Her work is as a receptionist for a car dealer and her hours are scattered over days, evenings and weekends. She has had a past history of panic attacks and recently experienced some palpitations.

12. 12 7. How do you monitor and manage co-morbidities within a scheduled office visit? Panelist

13. 13  If we were in your office for a day, what is the one pearl that you would like us to take home regarding the care of a patient with arthritis? Panelist

14. Thank you