Access to nonpharmacologic, interprofessional care in rheumatic and musculoskeletal diseases: an unmet need

Although numerous recommendations and clinical guidelines in rheumatology emphasise the importance of including multiple health professionals in disease management, the implementation of a comprehensive biopsychosocial approach remains limited in many healthcare systems. This viewpoint calls for action to promote access to evidence-based, nonpharmacologic interventions delivered by an interprofessional rheumatology team to reduce the impact of disease and improve the quality of life of people with rheumatic and musculoskeletal diseases (RMDs). We briefly describe the physical, psychological and social impacts of RMDs and provide evidence for nonpharmacologic interventions within a biopsychosocial framework. We argue that the persistent discrepancy between recommendations and the real-world implementation of person-centred, interprofessional care limits the opportunities to address unmet patient needs and optimise long-term outcomes. Despite major advances in pharmacological treatment, many people living with RMDs still experience substantial impact of their disease. International organisations, such as the European Alliance of Associations for Rheumatology and the American College of Rheumatology, have an important role in supporting the implementation of a biopsychosocial approach, through advocacy and legislative pressure, promoting patients' access to a broader rheumatology workforce alongside rheumatologists when needed. High-quality research is urgently needed to strengthen the evidence base for interprofessional team-based care, including socioeconomic evaluations and analyses of its long-term impact on health outcomes.