Repeated rheumatologist consultation (regions)

Repeat consultation is a new visit to the same specialist within 10 working days from the last consultation for the same medical condition.

Repeat rheumatology consultation represents the follow-up evaluation of a patient already known to have a rheumatic condition or suspected of having a rheumatic disease, who has previously undergone an initial consultation. This visit aims to monitor disease progression, assess the effectiveness and tolerability of treatment, adjust therapy, and interpret the results of laboratory tests or investigations performed.

Purpose

• Monitoring the patient’s clinical status.
• Optimizing treatment according to therapeutic response and new clinical/paraclinical data.
• Preventing complications and disease progression.

Role

The repeat consultation is essential in the management of chronic rheumatic diseases, as it allows treatment to be adapted according to the patient’s evolution, reduces risks, and helps maintain a good quality of life.

Objectives

• Evaluating the patient’s response to previous treatment.
• Monitoring disease activity using clinical scores (e.g., DAS28, SDAI, BASDAI).
• Interpreting the results of recent laboratory tests and investigations.
• Adjusting the therapeutic regimen, if necessary.
• Providing counseling regarding lifestyle, medication, and preventive measures.

Stages

• Reassessment of current symptoms: pain, stiffness, functionality.
• Physical examination focused on joints, mobility, edema, and systemic signs.
• Review of blood test results, imaging studies, or other investigations.
• Evaluation of treatment tolerability and possible adverse effects.
• Discussion and update of the treatment plan.
• Establishing the need for interdisciplinary consultations (e.g., orthopedics, dermatology).

Indications

• Monitoring an already diagnosed rheumatic condition.
• Reassessment after initiation or modification of treatment.
• Presence of new symptoms or worsening of existing ones.
• Adverse effects related to administered medications.
• Need to interpret investigation results.
• Periodic evaluation according to follow-up protocols (e.g., rheumatoid arthritis, lupus, spondylitis).

Procedure

• Updating recent medical history.
• Clinical examination and reassessment of objective signs.
• Discussion of test results.
• Adjustment of treatment, if required.
• Providing additional recommendations and scheduling the next follow-up visit.

Duration and scheduling of visits

• Consultation duration: 20–40 minutes.
• Repetition of tests/investigations: depending on disease evolution, every 1–3 months.
• Next follow-up visit: established individually, based on pathology and patient response.

The repeat rheumatology consultation is indispensable for monitoring disease progression and adapting therapeutic strategies. Through regular follow-up, the prevention of complications, preservation of joint function, and improvement of quality of life in patients with chronic rheumatic conditions are ensured.

 

Sources:

https://rheumatology.org/managing-your-rheumatic-disease 
https://www.sciencedirect.com/topics/medicine-and-dentistry/rheumatology
https://rheumatology.org/rheumatologist
https://www.rheumatologyadvisor.com/features/management-of-rheumatic-disease-the-interface-between-primary-care-and-rheumatology/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8616326/