SPECIAL REPORT: RHEUMATOID ARTHRITIS AND SEVERE PSORIASIS TREATMENT
guides to help patients self-administer
and provide support to help the patient live as active a life as possible. But of course the greatest impact is on the patient themselves. As with any long-term complaint, patients will need a lot of support, not just clinically but also psychologically. The NICE guidance makes the point that living with arthritis can be a positive experience – although challenging at times. To live well with arthritis the patient must understand that, while their condition is their reality, it is still possible to have a full rewarding life. It’s mainly a matter of managing that life. It also means the patient working with their doctor to implement the agreed treatment plan and accepting that, while the condition cannot currently be prevented (because the exact trigger for RA is not yet known), it is possible to live with it. Sometimes with rheumatoid arthritis, as with other long-term conditions, individual patients will want to try complimentary therapies and changes to diet. There is no strong evidence that their condition will benefit from either of these approaches but, as always, there may be some psychological value that the patient can gain from feeling in charge of at least this part of their treatment and there may well be some short-term symptomatic benefits. However these unconventional therapies should not replace conventional treatment or drugs. Carol Eustace was diagnosed with arthritis at the age of 19 and is now a writer on and patient advocate for others who live with the condition. She has created a ten-point ‘Living with Arthritis Checklist’ which can be found in full at click here. Some of the ideas that she suggests include that patients should have
unshakable perseverance, that they should take time to decompress and that ‘feeling sorry for yourself’ isn’t an option4. She also advises that RA patients should have a manageable and accessible home environment and ‘Someone to turn to for emotional support’.
Family Support Helps As well as being a potential life changer for the patient, rheumatoid arthritis can have an impact on the whole of their family. Families speak of the reassurance of statistics at the early diagnosis, such as that only 5% of sufferers end up in a wheelchair or that the condition is manageable. Both are true but the condition can nonetheless severely restrict what a sufferer can contribute to the family, in physical terms at least, and the family have the distress of seeing their loved one suffering from the symptoms of RA such as pain, lack of mobility and fatigue. Good and supportive families learn to read the condition almost before the sufferer can and to try and arrange family affairs to minimise unnecessary stresses on the patient. Working with the patient, taking an interest in the condition and researching for up-to-date information can at least make people feel that they are doing something.
A Manageable Condition While it would be wrong to minimise the severity of rheumatoid arthritis or psoriatic arthritis and its impact, it would be equally incorrect to be over pessimistic about the condition. Patients and their families can live with RA, albeit subject to careful management, sensible lifestyle adjustments and a proper clinical treatment programme. www.primarycarereports.co.uk | 9