Importance of patient education

Just yesterday, the Arthritis Foundation, Wisconsin Chapter staff and in-office volunteers, along with two members of the Wisconsin Arthritis Program were able to learn more about rheumatoid arthritis (RA) from Alma Hamidovic, PharmD. Alma is a pharmacist by training, but she serves a role at UCB as an Immunology Medical Science Liaison. What does that mean? She works with doctors and scientists in clinical trials with RA and lupus. She also provies education to doctors, insurance companies and interested groups like our staff. This is what Alma shared with us:

Alma Hamidovic, Pharm D., teaches staff and volunteers about rheumatoid arthritis.

Rheumatoid Arthritis is an autoimmune disease that affects joints and the surrounding tissue and cartilage causing swelling, pain, and stiffness. Three times more women get RA then men do when they’re younger, but as people age the incidence of RA in men and women is closer to 1:1. RA does affect more than just joints. It has a systemic affect on the body often affecting elbows, wrists, knees, ankles, and feet plus heart, lungs, eyes, skin, liver, blood, etc.

When a person has RA, the space around their joints called the synovium, which is a fluid sac that cushions the joints, becomes thin as does the space between the bone and damaged cartilage. Cells “flip out” and soon you have T-cells, B-cells, microphages, lymphocytes, mast cells and pannus wreaking havoc on a joint.

There’s a lot more to it than you thought, huh?

The causes of RA is unknown. There are studies that have shown that there are many factors which make a person more likely, however, to get the disease. They are genetic, hormonal, environmental, but there is little evidence showing that there are infectious causes. People who smoke are especially at risk.

When testing for how RA affects someone’s life, Alma showed us that stiffness, pain, swelling, limitations were all very high, but it doesn’t seem to negatively affect social and mental functioning. “Rheumatologists are always telling me how heroic the RA patients are,” Alma said. No matter how bad their RA gets, these individuals are brave and have a brilliance to their personalities.

So, how do you treat RA? Back in the early 1900’s, individuals were told to “take aspirin until your ears rang”. In the 1930’s, gold was injected into people’s joints. Why this works, no one is exactly sure, but the treatment is very painful. In the 1950’s, steroids were the latest and greatest. In the 1980’s, methotrexate, also used to treat cancer, came on the scene and has stayed. In the 1990’s and in this decade, biologic drugs and anti-TNF blockers have literaly turned people’s lives around. Fortunately the future for RA patients is brighter as new drugs are tested even as this author types. The first line of treatments was aimed at controlling pain. Then they found ways to prevent or slow destruction of the joints and bones making disfigurement from RA less likely. Now, researchers are looking for a cure and ways to put people in remission for good.

Besides these medicines, patient education has been shown to be a tremendous help as a non-pharmacological intervention. It’s right up there with therapy. The more you know, the better a patient you’ll be. The better patient you are, the more likely you are to having a great relationship with your rheumatologist, which will result in care and treatments that you understand and can embrace.

While we wait for that cure, you can contact the Arthritis Foundation at 800-242-9945 and ask for information about arthritis to enhance your knowledge. It sounds cheesy, but it’s really about what you know.

Tags: Arthritis, Information and Referral Service Hotline, Let's Talk RA, rheumatoid arthritis