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Elevating Rheumatic Disease Care: Case Challenges in Understanding and Addressing Health Disparities

  • Authors: Iris Navarro-Millán, MD, MSPH
  • CME / ABIM MOC / CE Released: 12/28/2022
  • Valid for credit through: 12/28/2023, 11:59 PM EST
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  • Credits Available

    Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 1.00 ABIM MOC points

    Nurses - 1.00 ANCC Contact Hour(s) (0.25 contact hours are in the area of pharmacology)

    IPCE - 1.0 Interprofessional Continuing Education (IPCE) credit

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for rheumatologists, dermatologists, primary care physicians (PCPs), nurse practitioners (NPs), physician assistants (PAs), nurses, and other healthcare professionals (HCPs) who provide care to patients with rheumatic disease.

The goal of this activity is for learners to be better able to recognize health disparities in rheumatologic care, specifically among patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) and mitigate inequities in their own practice through the application of evidence-based tools and strategies.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Assessment of social determinants of health for patients with rheumatic disease
    • Patient communication strategies
  • Have greater competence related to
    • Individualizing care for patients with rheumatic disease
  • Demonstrate greater confidence in their ability to
    • Provide equitable team-based care to patients with rheumatic disease


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All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.

Disclosures for additional planners can be found here.


  • Iris Navarro-Millán, MD, MSPH

    Assistant Professor of Medicine
    Weill Cornell Medicine
    Hospital for Special Surgery
    New York, New York


    Iris Navarro-Millán, MD, MSPH, has the following relevant financial relationships:
    Other: Served on an advisory board for Swedish Orphan Biovitrum


  • Karen Badal, MD, MPH

    Senior Medical Education Director, Medscape, LLC


    Karen Badal, MD, MPH, has no relevant financial relationships.

  • Ashley Stumvoll, MRes

    Associate Medical Writer, Medscape, LLC


    Ashley Stumvoll, MRes, has no relevant financial relationships.

Compliance Reviewer/Nurse Planner

  • Leigh Schmidt, MSN, RN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC


    Leigh Schmidt, MSN, RN, CNE, CHCP, has no relevant financial relationships.

Accreditation Statements


Interprofessional Continuing Education

In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


This activity was planned by and for the healthcare team, and learners will receive 1.0 Interprofessional Continuing Education (IPCE) credit for learning and change.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

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    For Nurses

  • Awarded 1.0 contact hour(s) of nursing continuing professional development for RNs and APNs; 0.25 contact hours are in the area of pharmacology.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

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There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.


Elevating Rheumatic Disease Care: Case Challenges in Understanding and Addressing Health Disparities

Authors: Iris Navarro-Millán, MD, MSPHFaculty and Disclosures

CME / ABIM MOC / CE Released: 12/28/2022

Valid for credit through: 12/28/2023, 11:59 PM EST



  1. Fraenkel L, et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthrit Care Res. 2021;73:924-939.
  2. Barhamain AS, et al. The journey of rheumatoid arthritis patients: a review of reported lag times from the onset of symptoms. Open Access Rheumatol. 2017;9:139-150.
  3. Yip K, et al. Racial, ethnic, and healthcare disparities in rheumatoid arthritis. Curr Opin Rheumatol. 2020;33:117-121.
  4. George MD, et al. Disruptions in rheumatology care and the rise of telehealth in response to the covid-19 pandemic in a community practice–based network. Arthrit Care Res. 2021;73:1153-1161.
  5. Chu L, et al. Racial/ethnic differences in the use of biologic disease-modifying antirheumatic drugs among California Medicaid rheumatoid arthritis patients. Arthrit Care Res. 2013;65:299-303.
  6. Navarro-Millán I, et al. Racial and ethnic differences in medication use among beneficiaries of social security disability insurance with rheumatoid arthritis. Semin Arthritis Rheu. 2020;50:988-995.
  7. Boytsov NN, et al. Health care effect of disease-modifying antirheumatic drug use on patients with rheumatoid arthritis. J Manag Care Spec Ph. 2019;25:879-887.
  8. Putrik P, et al. Inequities in access to biologic and synthetic DMARDs across 46 European countries. Ann Rheum Dis. 2014;73:198.
  9. Feldman CH, et al. Assessing the need for improved access to rheumatology care. J Clin Rheumatology. 2013;19:361-366.
  10. Robinson PC, et al. Time to treatment in rheumatoid arthritis. J Clin Rheumatology. 2010;16:267-273.
  11. Chalabian J, et al. Impact of language barrier on quality of patient care, resident stress, and teaching. Teach Learn Med. 1997;9:84-90.
  12. Katz PP, et al. Poverty, depression, or lost in translation? ethnic and language variation in patient-reported outcomes in rheumatoid arthritis. Arthrit Care Res. 2016;68:621-628.
  13. Pathak EB, et al. Stoic beliefs and health: development and preliminary validation of the Pathak-Wieten Stoicism Ideology Scale. Bmj Open. 2017;7:e015137.
  14. Cutolo M, et al. Burden of disease in treated rheumatoid arthritis patients: Going beyond the joint. Semin Arthritis Rheu. 2014;43:479-488.
  15. Dey M, et al. Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review. Rmd Open. 2022;8:e002058.
  16. Massardo L, et al. Early rheumatoid arthritis in Latin America: Low socioeconomic status related to high disease activity at baseline. Arthrit Care Res. 2012;64:1135-1143.
  17. Navarro-Millán I, et al. Comparing cardiovascular risk of patients with rheumatoid arthritis within the Social Security Disability Insurance with those commercially insured. Arthritis Res Ther. 2022;24:202.
  18. Singh JA, et al. 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis Rheumatol. 2019;71:5-32.
  19. Hsu DY, et al. The inpatient burden of psoriasis in the United States. J Am Acad Dermatol. 2016;75:33-41.
  20. Yadav G, et al. Unmet need in people with psoriasis and skin of color in Canada and the United States. Dermatology Ther. Published online 2022:1-13.
  21. Hermann AE, et al. Presentations of cutaneous disease in various skin pigmentations: plaque psoriasis. Hca Healthc J Med. 2022;3.
  22. Scheufele CJ, et al. Presentations of cutaneous disease in various skin pigmentations: an introduction. Hca Healthc J Med. 2022;3.
  23. Alexis AF, et al. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthetic Dermatol. 2014;7:16-24.
  24. Georgopoulou S, et al. Physician–patient communication in rheumatology: a systematic review. Rheumatol Int. 2018;38:763-775.
  25. Barak LC, et al. Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators. Bmc Med Educ. 2022;22:806.
  26. Merola JF, et al. Incidence and prevalence of psoriatic arthritis in patients with psoriasis stratified by psoriasis disease severity: Retrospective analysis of an electronic health records database in the United States. J Am Acad Dermatol. 2022;86:748-757.
  27. Gisondi P, et al. Reducing the risk of developing psoriatic arthritis in patients with psoriasis. psoriasis Targets Ther. 2022;12:213-220.
  28. Ogdie A, et al. Racial differences in prevalence and treatment for psoriatic arthritis and ankylosing spondylitis by insurance coverage in the USA. Rheumatol Ther. 2021;8:1725-1739.
  29. Shwe S, et al. Racial disparities in clinical trials of biologic treatments for psoriatic arthritis. J Am Acad Dermatol. 2021;87:910-912.
  30. Takeshita J, et al. Racial differences in perceptions of psoriasis therapies: implications for racial disparities in psoriasis treatment. J Invest Dermatol. 2019;139:1672-1679.e1.
  31. Hammond WP. Psychosocial correlates of medical mistrust among African American men. Am J Commun Psychol. 2010;45:87-106.
  32. Sumpton D, et al Patients' Perspectives on shared decision-making about medications in psoriatic arthritis: an interview Study. Arthritis Care Res (Hoboken). 2021. doi: 10.1002/acr.24748. [Epub ahead of print].
  33. Lofland JH. Shared decision-making for biologic treatment of autoimmune disease: influence on adherence, persistence, satisfaction, and health care costs. Patient Prefer Adher. 2017;11:947-958.
  34. Yen PH, et al. Use and effectiveness of the teach-back method in patient education and health outcomes. Fed Pract Heal Care Prof Va Dod Phs. 2019;36:284-289
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