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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Related Experiment Video

Updated: Apr 14, 2026

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How Do Patient Decision Aids Enable Purposeful Shared Decision-Making in Rheumatology? An Integrative Review.

Bharat Kumar1, Ibiyemi Oke1, Ruoning Ni1

  • 1Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|April 13, 2026
PubMed
Summary
This summary is machine-generated.

This review found that most rheumatology patient decision aids (PDAs) focus on treatment options, with fewer addressing conflict or problem-solving. Opportunities exist to expand PDA scope for purposeful shared decision-making (PSDM) in rheumatology.

Keywords:
patient educationpatient experienceshared decision making

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Area of Science:

  • Rheumatology
  • Health Services Research
  • Patient Decision Making

Background:

  • Shared decision-making (SDM) is crucial for patient-centered care, involving collaborative health decisions between patients and clinicians.
  • Purposeful shared decision-making (PSDM) offers a contextual approach to SDM, acknowledging its complexity across diverse healthcare settings.
  • Patient decision aids (PDAs) are tools designed to support patients in making informed health choices.

Purpose of the Study:

  • To systematically identify and review rheumatology patient decision aids (PDAs) in published literature.
  • To assess how identified PDAs support purposeful shared decision-making (PSDM) across different contexts.
  • To evaluate the quality of studies reporting on the evaluation of PDAs using the SUNDAE Checklist.

Main Methods:

  • An integrative review systematically searched Ovid MEDLINE, EMBASE, CINAHL, and PsycINFO databases (1948-2023).
  • Author contact and reference scanning supplemented the database search.
  • PDAs were classified into four modes, and manuscript quality was assessed using the 26-item SUNDAE Checklist.

Main Results:

  • Forty-six records met inclusion criteria, with 21 original PDAs identified across 23 articles.
  • Rheumatoid arthritis (n=8), osteoarthritis (n=7), and lupus nephritis (n=3) were the most represented conditions.
  • Fifteen PDAs focused on weighing treatment options (mode 1), while fewer addressed conflict (mode 2, n=6) or problem-solving (mode 3, n=2).

Conclusions:

  • There is a need to develop and refine PDAs that address a broader range of PSDM modes beyond just treatment options.
  • Opportunities exist to expand the coverage of PDAs to a wider spectrum of rheumatologic conditions.
  • Enhanced transparency in reporting the evaluation of PDA content, development, and delivery is recommended.