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25th Oct


Report on the 2017 EULAR Annual European Congress of Rheumatology, Madrid, Spain

by Emma Bavage

On the 10th June I started a 28 hours journey to Madrid to attend my first ever EULAR conference.  With over 10000 delegates and up to 13 concurrent sessions running, the conference venue was like a small city filled with a variety of clinicians, scientists, media, pharmaceutical industry employees and consumers.

The program had a huge variety of contributions inclusive of basic science, clinical and specific streams from Health Professions in Rheumatology (HPR) and consumers (People with Arthritis and Rheumatism in Europe (PARE)).  I chose and attended sessions that were clinical and patient focused which would make a difference to my learning and clinical practice.  I had the opportunity to network with other rheumatology health care professionals including rheumatology nurse practitioners, which was invaluable with my nurse practitioner studies coming to an end.


The increasing incidence of gout was highlighted in a few sessions throughout the conference with a rise in acute care health expenditure and continued poor management at the primary health care level.  One presenter even described gout as the worst managed chronic disease in the western world.  Increasing obesity, western diets and fructose consumption all increase risk of gout.  Michael Doherty from the UK presented an abstract of a 2 year randomized control trial of GP led v nurse led care of gout with results strongly favouring the nurse led care for medication titration, clinical outcomes and serum urate levels.  I look forward to reading the full study when it is published.

In the HPR program there were some excellent sessions on how nurses and other health care professionals are shaping patient outcomes with management of co-morbidities such as cardiovascular disease risk, vaccinations and osteoporosis with many nurse led care models showing excellent outcomes.

Paul Kirwan a physiotherapist from Dublin presented the opportunity that physiotherapists and other health care professionals have in the early detection of inflammatory arthritis by referring to rheumatology clinics to ensure timely treatment for these patients.  He presented a mnemonic for screening for inflammatory arthritis SCREEND’EM (S- skin, C- colitis or Crohns, R- relatives (family history), E- eyes, E- early morning stiffness, N- nocturnal pattern, nails and number of joints, D- dactylitis, E- enthesitis, M- medication effect and movement) that can be used by a variety of health care professionals inclusive of GPs.

A. Turah presented telehealth follow up by specialist rheumatology nurses v rheumatologists in patients with low disease activity in RA.  Patients had similar outcomes in the rheumatologist arm and the nurse arm.  I found this session particularly relevant to the Australian context given our geographical expanse and issue with rheumatology access in rural and remote areas.

Whilst we know that many of our patients are at increased risk of herpes zoster (shingles) due to immunosuppression and disease states there still remains uncertainty about when to vaccinate and what the risks are.  This session on this topical subject was excellent.  It discussed the need for the vaccine in older patients with rheumatic diseases and that it is safe to give to patients on traditional DMARDs as long as prednisolone was less than 20mg daily.  It is contraindicated to be given whilst patients are on bDMARDs.

I wish to thank the RHPA for giving me the fabulous opportunity to attend EULAR and I could never have managed to get there without their support.  I encourage all other members to take the opportunity to apply for these scholarships as it has been an invaluable experience for me and has made a difference to my practice.

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