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The Importance of Monitoring and Managing Quality of Life in RA

The Importance of Monitoring and Managing Quality of Life in RA



Time to Complete

1 hour


October 12, 2012


April 12, 2013

Program Description

Rheumatoid arthritis (RA) is associated with substantial pain, fatigue, disability, depression, and an increased risk of morbidity and mortality. The negative effects of RA on both physical and psychological health can be quantitatively assessed through the use of validated health-related quality-of-life (HRQOL) assessment tools. HRQOL correlates with disease activity and predicts mortality risk in patients with RA. HRQOL assessments are essential for gauging the effects of RA on an individual’s daily life, the effectiveness of the current treatment, and whether any changes in therapy are needed. Effective RA treatment has been shown to improve HRQOL at all stages of disease: in early RA, after failure of methotrexate, and after failure of a tumor-necrosis-factor (TNF) inhibitor. Long-term clinical trials have shown that current treatment paradigms can maintain HRQOL and prevent disability; thus, it is critical that patients with RA obtain proper care by a rheumatologist early in the disease course.

Educational Objectives

As a result of participating in this educational activity, learners will be better able to:
  • Identify how RA can negatively affect HRQOL by impairing physical and psychological health

  • Compare validated tools commonly used to assess HRQOL in patients with RA

  • Evaluate the effect of RA therapies on HRQOL in early RA and in patients with established disease

  • Incorporate HRQOL monitoring into the assessment of patients with RA


According to the disclosure policy of the Academy, all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relevant relationships with any commercial interests related to this activity. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity and levels of evidence. Disclosures are as follows:

Stanley B. Cohen, MD
Advisory Board – for scientific purposes: Bristol-Myers Squibb, Pfizer
Consultant – for clinical trial design: Amgen, Astellas Pharma, Dynavax, Pfizer
Grant/Research Support: Astellas Pharma, Amgen, Biogen-IDEC, Bristol-Myers Squibb, Genentech, Janssen (Centocor), Johnson & Johnson, Lilly, Merck, Pfizer, Hoffman-La Roche, Sanofi, UCB (Medical Director for Clinical Trials Center; Center has received grants for clinical trials.)

William F.C. Rigby, MD (Activity Director)
Advisory Board – for scientific information: Bristol-Myers Squibb, UCB Pharma
Consultant – for marketing purposes: Hoffman-La Roche
Consultant – for clinical trial design: Crescendo Bioscience, Hoffman-La Roche
Promotional Speakers’ Bureau: Hoffman-La Roche

Independent Clinical Peer Reviewer
Rodolfo V. Curiel, MD
, Assistant Professor of Medicine, Rheumatology Fellowship, Program Director, The George Washington University, Washington, DC: No relevant financial relationships with any commercial interests.

Planning Committee
John JD Juchniewicz, MCIS, CCMEP, American Academy of CME and Deborah Dean, Michelle Yechout, and Melinda Tanzola, PhD (editorial assistance provided), Alliance Medical Communications: No relevant financial relationships with any commercial interests.

Unapproved Product Use
This activity will not review off-label or investigational information.

This activity is designed for use by health care professionals for educational purposes only. The opinions expressed in this educational activity are those of the faculty, and do not represent those of the Academy or Alliance Medical Communications. This activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically, and draw conclusions only after careful consideration of all available scientific information.

In addition, the American Academy of CME requires all faculty/authors to note the level of evidence for any patient care recommendation made during their presentations. For this activity, the Academy used the Category of Evidence and the Strength of Recommendation classification schemes from the 1999 British Medical Journal Clinical Guidelines (Shekelle PG, et al. Clinical Guidelines: Developing Guidelines. BMJ. 1999;318(7183):593-596.) for levels of evidence.

Category of Evidence:
 Ia Evidence for metaanalysis of randomized controlled trials
 Ib  Evidence from at least one randomized controlled trial
 IIa Evidence from at least one controlled study without randomization
 IIb Evidence from at least one other type of quasiexperimental study
 III Evidence from nonexperimental descriptive studies, such as comparative studies, correlation studies, and casecontrol studies
 IV Evidence from expert committee reports or opinions or clinical experience of respected authorities, or both

Strength of Recommendation:
 A  Directly based on category I evidence
 B   Directly based on category II evidence or extrapolated recommendation from category I evidence
 C  Directly based on category III evidence or extrapolated recommendation from category I or II evidence
 D  Directly based on category IV evidence or extrapolated recommendation from category I, II or III evidence

The information presented at this activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician regarding diagnosis and treatment of a specific patient’s medical condition.


Stanley B. Cohen, MD
Clinical Professor
Department of Internal Medicine
Southwestern Medical School
Dallas, Texas

William F.C. Rigby, MD (Activity Director)
Professor of Medicine, Microbiology and Immunology
Division of Rheumatology
Department of Medicine
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire

Accredited Provider

Jointly sponsored by:

If you have any questions relating to the accreditation for this activity, please contact:
John JD Juchniewicz, MCIS, CCMEP
American Academy of CME, Inc.
2275 West County Line Road
Suite 6-329
Jackson, NJ 08527
Commercial Supporter
Support for this activity has been made possible through an independent educational grant from

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Intended Audience

This activity has been designed for rheumatologists and internists who provide care and support to patients with rheumatoid arthritis. Clinical nurse specialists, nurse practitioners, physician assistants and other healthcare professionals may also participate.




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of CME and Alliance Medical Communications. The American Academy of CME is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The American Academy of CME designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


There are no fees to participate in the activity. Participants must review the CME information including the learning objectives and disclosure statements, as well as the content of the activity. To receive CME credit for your participation, please complete the post-test (achieving a passing grade of 70% or greater), and program evaluation.

If you have any other questions relating to your certificate or other issues with this activity, please contact

© 2012. This CME-certified activity is held as copyrighted © by the American Academy of CME and Alliance Medical Communications. Through this notice, the Academy and Alliance Medical Communications grant permission of its use for educational purposes only. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owner(s).


Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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