Working with PCPs - II
Updated: May 21
The Key Articles: Sjogren’s Annotated Bibliography page is a great way to share Sjogren’s information with your clinicians. By taking just a few minutes to read the annotations (summaries written in brown-colored font), clinicians can gain a quick overview of key clinical concepts. While this resource was designed with PCPs in mind, it can be helpful for various specialists who are often unaware of the spectrum and severity of the disease.
Some rheumatologists may be interested in reading this handout; others may not be as receptive. Use your best judgement! Regardless, all rheumatologists should be given a copy of the Clinical Practice Guidelines for Systemic Features, which is Item 1.b. of the information packet below. These guidelines are not published on the American College of Rheumatology (ACR) website, the go-to resource for most rheumatologists. Therefore, many remain unaware that these exist.
How to use a general information packet in your PCP visit
1. Print a general information packet that includes the following three items, all available on the Sjogren’s Advocate website.
b) Clinical Practice Guidelines for Systemic Features and Pulmonary Manifestations in Sjogren's. Click and print the PDFs
c) PCP letter
NOTE: Eye and dental providers also benefit from the general information packet in addition to the Clinical Practice Guidelines for ocular and oral management.
2. Use the Key Articles handout (1.a. above) to advocate for your concerns. Encourage your PCP to read the annotations (brown font), pointing out that these articles are handpicked for PCPs. They are updated periodically, so be sure to print out the most recent copy.
3. Q&A for countering dismissive attitudes and misperceptions
Q: What if I am told that Sjogren’s is not serious or does not need to be followed?
A: Point out articles # 1 and 2 as well as # 12 in the Mortality section of key articles. The Sjogren's is Always Systemic page of this website, backed by many research studies, can be used to make a case for why every Sjogren's patient deserves comprehensive care.
Q: What if my clinician downplays or psychologizes pain and fatigue?
A: Point out key articles # 4-7 that support the understanding that these direct Sjogren’s features have a biological basis.
Q: What if my rheumatologist/clinician claims that certain strict criteria, especially blood tests, must be positive for a Sjogren’s diagnosis?
A: Point out Key Article #1 from Dr. Vivino in the Review Articles (see item 7 in his article), and suggest that they review the diagnosis section of Sjogren's Advocate.
1. Check for document updates to make sure you print out the latest PDF version of Key Articles.
2. While the Key Articles do overlap with the Citations (a separate link in the footer), they serve different purposes. The Key Articles point out core clinical concepts. The Citations indicate the sources that I consulted when writing a particular statement or section on the website.
3. To obtain copies of articles that are not Open Access, try requesting them from a nearby medical school library. Many health libraries offer this as a free service to the community. I have used the Stanford Health Library for this in the past. If I could chose just one succinct overview of Sjogren's, it would be Dr. Vivino’s review article (2). I highly recommend that every PCP and rheumatologist read Kathy Hammitt's article, Sjogren's: the patient's perspective.