Conversations in rheumatoid arthritis (ra) therapy questionaire

Rheumatoid Arthritis Discussion Guide for Use with Your Doctor After reviewing your medical history, test results, and the safety and efficacy of various therapeutic options, your doctor has determined that a biologic agent is the appropriate treatment for your rheumatoid arthritis. In order to ensure this treatment is effective, strong communication between you and your doctor is essential.1 Biologic agents are medications that help decrease inflammation and structural damage to the joints by interrupting the cascade of events that cause inflammation.The goals of your treatment include relieving pain, decreasing inflammation, and slowing down or stopping joint damage.1 Throughout treatment, it is important for you to regularly visit your doctor for routine monitoring and ongoing care.

This will help your doctor assess the effectiveness of your treatment, including negative effects of medications that could necessitate the modification of your treatment plan.1 Potential side effects of biological therapies include redness, swelling, itching, bruising, or pain at the site of administration. Other possible side effects include sinus infection, headache, nausea, or diarrhea. Rare but serious side effects that can occur include serious infections or cancer.2 Self-Injection

Infusion

You inject yourself after proper training by a doctor or nurse

Infusion is prepared and given by a doctor, nurse, or trained healthcare professional

You fill the prescription and store medication in refrigerator

Your doctor prescribes and a healthcare professional stores your medication until the time of your infusion

Where

Treatment is usually self-injected at home, after you receive proper training

Treatment is given at your doctor’s office or infusion center

How

Injected under the skin of your abdomen or thigh

Infusion through a needle placed in a vein, usually in your arm

Frequency varies (once a week or less often), depending on the medication used

As often as once a month or less often, depending on the medication used

Prefilled injection device with fixed amount of medication for each dose

Your blood pressure, heart rate, temperature, and weight will be checked before each treatment

Dispose of the injection device in a sharps container and follow your community guidelines on how to dispose of the container once it is full

Amount of medication for each dose based on your weight

Who

Taken with methotrexate, as directed

Taken with methotrexate, depending on medication, as directed Requirements

Training Manual dexterity n Good vision n Refrigerator to store medication before use n Container to safely dispose of used syringe n

n

Ability to travel to appointments

n

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The following questions are meant to help you and your doctor decide whether infusion at your doctor’s office or clinic, or self-injection at home, is better suited to you and your individual needs.

How often will I need treatment? n

n

Infusion treatment can be administered as often as once a month or less often, depending upon the medication.

Infusion time varies by medication.

Self-injection treatment can be done by you or a caregiver, after training from your doctor or nurse, as often as once a week or less often, depending upon the medication.

Where will my treatment take place? n

Infusion is prepared and given by a healthcare professional at a doctor’s office or infusion center.

n

Self-injection is prepared and given by you or your caregiver in your home, requiring you to keep all the

medication and supplies on hand.

How will my treatment be administered? n

Infusion is prepared and given by a healthcare professional through a needle placed in a vein, usually in your arm.

n

For self-injection treatment, you will prepare and give yourself an injection just below the surface of your skin in

your abdomen or thigh, after training by your doctor or nurse.

Support and safety n

Do you have any physical limitations that might interfere with your ability to self-inject?

n

Do you have support at home to help you if you need it?

n

Do you have a good place to safely store your medication in your refrigerator, out of the reach of children?

n

Do you have a safe place to store a sharps disposal container with used syringes, out of the reach of children

and pets?

For full details on what to tell your doctor, both before you begin treatment and after treatment has begun, please see the Medication Guide for the product that your doctor has prescribed for you. The U.S. Food and Drug Administration requires that medication guides be provided with certain prescribed drugs and biologic products.

REFERENCES 1. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Handout on health: rheumatoid arthritis. http://www.niams.nih.gov/Health_Info/ Rheumatic_Disease/default.asp. Accessed January 21, 2014.

2. Agency for Healthcare Quality and Research. Medicines for rheumatoid arthritis: a review of the research for adults. AHRQ Pub. No. 12(13)-EHC025-A. November 2012.

3. American College of Rheumatology. Anti-tumor necrosis factor fact sheet. http://www.rheumatology.org/Practice/Clinical/Patients/Medications/ Anti-TNF/. Accessed January 5, 2014..

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