My Treatment Approach to Rheumatoid Arthritis

Davis, John M.; Matteson, Eric L.

doi:10.1016/j.mayocp.2012.03.011

Cited by 90 publications

(68 citation statements)

References 97 publications

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“…Studies have shown that early and aggressive treatment with disease modifying anti-rheumatic medications can minimize inflammation and cause low disease activity and sometimes remission. [4,[21][22][23] Such patients are usually from the point of diagnosis expected to incorporate a medication regimen into their daily lives, for the rest of lives. The introduction of chronic medication into a patient's life often means that new behavioral patterns need to be established but if the message is not clear, for any factors, accurately understood by the patient; the patients' well-being is further compromised.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting medication adherence among patients with rheumatic disorders

Ismail

Selim²,

Elkhashab³

2017

JNEP

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Background and objective: Patient's adherence is an important factor affecting the successful maintenance of treatment, slow progression of the disease; reduce costs of health care especially in the presence of multiple chronic conditions as rheumatic disorders. While, medication non-adherence is a significant problem leads to increased mortality and morbidity. So, identification of the factors affecting non-adherence to medication regimens is beneficial for healthcare providers to improve patient's health condition. The aim of the study was to determine factors affecting medication adherence among sample of Egyptian patients with rheumatic disorders.Methods: Design: An exploratory descriptive research design. Subjects: Purposive sampling of patients with history of rheumatic disorders. Setting: The study was carried out in rheumatology department and medical wards at Al-Kaser Al-Aini hospital. Tool: Patient Preliminary Informational Variables, Morisky Medication Adherence Scale 8-Items and Factors affecting drug adherence checklist were used to collect pertinent data.Results: The study showed 59.2% of study group had low adherence, followed by medium adherence and high adherence (28%, 12.7%) to prescribed medications respectively. Findings also; revealed that the highest percent of these factors that may combine to render patients to be less able to adhere to prescribed medication ranked as complexity of medication regimen; chronic conditions, restricted formularies, changing medications covered on formularies; fear of possible adverse effects, fear of dependence; lack of continuity of care, treatment interferes with lifestyle or requires significant behavioral changes; patient information materials written at too high literacy level; severity of symptoms; lack of knowledge on adherence and the effective interventions for improving it; as well the medication cost; long wait times; burdensome schedule; poor access or missed appointments; actual or perceived unpleasant side effects; duration of therapy; medication negative effect on liver and kidney; in addition, psychosocial stress, anxiety and anger.Conclusions: Due to the diversity of causes of non-adherence, the health care professionals must understand factors affecting medication adherence when dealing with problems of medication adherence especially with chronic conditions as rheumatic disorders. Recommendation: Interventions for overcoming factors affecting adherence must become a central component of efforts to improve patients' health worldwide. This could be done by proper determination for factors affecting medication adherence, also to consider patient condition individually and modify the treatment approach accordingly.

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Section: Discussionmentioning

confidence: 99%

Factors affecting medication adherence among patients with rheumatic disorders

Ismail

Selim²,

Elkhashab³

2017

JNEP

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“…1 The systemic inflammation process moreover has to be seen as a risk factor for increased prevalence of cardiovascular comorbidities. 2,3 Despite the success of highly effective pharmacotherapy in RA in last decades, rates of total joint arthroplasty (TJA) in RA remain static.…”

Section: Introductionmentioning

confidence: 99%

Cementless femoral components in bicondylar hybrid knee arthroplasty in patients with rheumatoid arthritis: A 10-year survivorship analysis

Hotfiel

Carl

Eibenberger

et al. 2017

J Orthop Surg (Hong Kong)

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Background: Total knee arthroplasty (TKA) has been established as a successful surgical treatment in the late stages of rheumatoid joint destruction. The purpose of this study was to review the clinical outcome and survivorship in rheumatoid arthritis (RA) patients undergoing TKA in hybrid technique with a cementless fixation of the femoral component. Methods: We analysed retrospectively 66 RA patients who underwent 72 TKAs (P.F.C. Sigma ® ). Mean follow-up time was 124 + 41 months. To evaluate postoperative clinical outcome, knee injury and osteoarthritis outcome score (KOOS) and Oxford knee score (OKS) were assessed. Kaplan-Meier analysis was used to calculate survivorship. The primary outcome was revision for any reason. Results: Thirty-four patients (36 knees) died and two patients (2 knees) were lost to follow-up. Three patients (four knees) did not agree to participate. Twenty-seven patients (30 knees) were available for assessing clinical scores. The average scores were 85 + 14 for KOOS and 34 + 10 for OKS. In three patients (three knees), revision was necessary, including restricted range of motion (n ¼ 1), instability (n ¼ 1), and infection (n ¼ 1). There were no cases of loosening in this cohort study. The survival rates were 100% at 5 years, 97.1% at 10 years (95% CI 89.0-99.2%) and 95.6% at 15 years (95% CI 86.9-98.5%). Conclusions: This study confirms that excellent clinical results and a good 10-year survivorship can be obtained with hybrid fixation technique in TKA in the unique population of RA patients.

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“…Diagnostic imaging techniques include computed tomography scan, magnetic resonance imaging, arthrography, and arthromography. 4 The present study was conducted to evaluate movements of mandible in geriatric patients suffering from RA with or without TMJ dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Intricate Estimation and Evaluation of Mandibular Movements in Geriatric Patients Suffering from Rheumatoid Arthritis

Dev

Perti

Garhnayak

et al. 2017

The Journal of Contemporary Dental Practice

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Background: Rheumatoid arthritis (RA) is an autoimmune disorder that usually affects joints and making them warm, painful, and swollen. The chief purpose of this study was to evaluate movements of mandible in geriatric patients suffering from RA with or without temporomandibular joint dysfunction. Materials and methods:A total of 45 people were included in this study with age of 60 years and above. Partially or completely edentulous patients were divided into experimental and control group. Experimental group consists of 20 people suffering from arthritis and control group consists of 25 people without arthritis. Movements were recorded with or without prosthesis while mastication in both experimental and control group.Results: Statistical evaluation of two studied groups showed decrease opening angle (p < 0.05) during mastication; however, insertion of new prosthesis showd a significant increase in values in both groups, with an increase in opening and closing angles. Conclusion:Positive correlation was found between arthritis and movements of the mandible in older people suffering from RA.Clinical significance: Patients suffering from RA are having restricted mandibular movements thus imposing an overall negative impact however; presence of prosthesis has been shown to enforce a positive effect on mandibular movement.

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My Treatment Approach to Rheumatoid Arthritis

Cited by 90 publications

References 97 publications

Factors affecting medication adherence among patients with rheumatic disorders

Factors affecting medication adherence among patients with rheumatic disorders

Cementless femoral components in bicondylar hybrid knee arthroplasty in patients with rheumatoid arthritis: A 10-year survivorship analysis

Intricate Estimation and Evaluation of Mandibular Movements in Geriatric Patients Suffering from Rheumatoid Arthritis

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