It is important that patients’ broader health needs are addressed
Rheumatoid arthritis and seronegative spondyloarthropathies are the most common types of inflammatory arthritis. They cause pain, joint damage and progressive functional loss, which limit participation in life and constitute a significant disease burden.1,2 Over the past decades, great advances in management, with the availability of corticosteroids, synthetic disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs, have significantly improved the disease control and outcomes. The guidelines, whose algorithms focus on drug prescription to achieve remission of disease,3,4 support everyday treatment. However, while they provide direction for the use of DMARDs, they do not consider the patients’ broader health needs.
- 1. Dagfinrud H, Kjeken I, Mowinckel P, et al. Impact of functional impairment in ankylosing spondylitis: impairment, activity limitation, and participation restrictions. J Rheumatol 2005; 32: 516-523.
- 2. Cross M, Smith E, Hoy D, et al. The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014. doi:10.1136/annrheumdis-2013-204627.
- 3. Singh JA, Saag KG, Bridges SL, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2016; 68: 1-26.
- 4. Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol 2016; 68: 282-298.
- 5. Hewlett SA. Patients and clinicians have different perspectives on outcomes in arthritis. J Rheumatol 2003; 30: 877-879.
- 6. Wluka AE, Chou L, Briggs AM, Cicuttini FM. Understanding the needs of consumers with musculoskeletal conditions. Consumers’ perceived needs of health information, health services and other non-medical services: a systematic scoping review. Melbourne: MOVE muscle, bone and joint health; 2016.
- 7. Nagy G, van Vollenhoven R. Sustained biologic-free and drug-free remission in rheumatoid arthritis, where are we now? Arthritis Res Ther 2015; 17: 181.
- 8. Bauman AE, Fardy JH, Harris PG. Getting it right: why bother with patient-centred care? Med J Aust 2003; 179: 253-256. <MJA full text>
- 9. Stacey D, Légaré F, Col NF, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2014: CD001431.
- 10. Arthritis Australia. Time to move: rheumatoid arthritis. A national strategy to reduce a costly burden. Sydney: Arthritis Australia; 2014. http://www.arthritisaustralia.com.au/images/stories/documents/reports/TTM/Final%20Arthriris%20Ausr%20Time%20to%20Move_RA_140612.pdf (accessed Dec 2016).
- 11. Morand EF, Leech MT. Successes, challenges and developments in Australian rheumatology. Nat Rev Rheumatol 2015; 11: 430-436.
- 12. Briggs AM, Fary RE, Slater H, et al. Disease-specific knowledge and clinical skills required by community-based physiotherapists to co-manage patients with rheumatoid arthritis. Arthritis Care Res (Hoboken) 2012; 64: 1514-1526.
- 13. Speerin R, Slater H, Li L, et al. Moving from evidence to practice: models of care for the prevention and management of musculoskeletal conditions. Best practice and research. Best Pract Res Clin Rheumatol 2014; 28: 479-515.
- 14. Slater H, Dear BF, Merolli MA, Briggs AM. Use of ehealth technologies to enable implementation of musculoskeletal models of care: the evidence and practice. Best Pract Res Clin Rheumatol 2016; 30: 483-502.
- 15. Walsh L, Hill S, Wluka AE, et al. Harnessing and supporting consumer involvement in the development and implementation of Models of Care for musculoskeletal health. Best Pract Res Clin Rheumatol 2016; 30: 420-444.
- 16. Lempp H, Scott DL, Kingsley GH. Patients’ views on the quality of health care for rheumatoid arthritis. Rheumatology (Oxford) 2006; 45: 1522-1528.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.