Rheumatoid Arthritis: A patient’s journey Flashcards
1
Q
what is inolved in Rheumatology follow up?
A
- Early Arthritis Clinic (nurse-led)
- Monthly appointments
- Monitoring disease activity (DAS28)
- Monitoring blood tests
- Patient education
- Multidisciplinary assessment
- Escalation of treatment
2
Q
how do you monitor disease activity?
A
Disease activity score
Measures all the joints
Only knees in lower limbs but may have it in ankles and feet
Inflammatory test – ESR or CRP
Ask patient how they feel on a scale of 0 to 100
3
Q
Early RA Multidisciplinary Clinic - who is involved?
A
- Rheumatology Specialist Nurse
- Rheumatology Occupational Therapist
- Rheumatology Physiotherapist
- Pharmacist
- Clinical Psychologist
- Podiatrist
- Orthotics
4
Q
what may some complications be?
A
•Orthopaedic intervention:
- Chronic synovitis
- Mechanical deformities
- Secondary osteoarthritis
- Poor function
- Pain
•Extra-articular involvement:
- Rheumatoid nodules
- Interstitial lung disease
- Vasculitis
- Cardiovascular risk
- Socio-economic
5
Q
what is the Socio-economic impact?
A
- Direct costs to the NHS and associated healthcare support services
- Indirect costs to the economy, including the effects of early mortality and lost productivity
- Personal impact and subsequent complications for patients and their families
- Approximately one third of people stop work within 2 years of onset
6
Q
Functional impairment - what are some aids that may be used?
A
- Vertebral fractures <- osteoporosis
- Special adaptive cutlery
- Special footwear
- Walking aids
- Use of wheelchair for outdoors
- Supportive family
- Care package
7
Q
Conclusion:
Early _______ and treatment of patients with rheumatoid arthritis is paramount
_____________ team input is essential
Close monitoring with treatment _________ if required
A
diagnosis
Multidisciplinary
escalation
