2024-01-09 10:10:36
To improve communication between healthcare workers and patients with arthritis or spindyloarthritis, the National Arthritis Coordinator (ConArtritis) proposes eleven recommendations to encourage shared decision-making and establish a productive and satisfactory dialogue.
Physiotherapist giving therapy to a woman’s knee. Image courtesy of ConArtritis
At the time of diagnosis, patients with arthritis and spondyloarthritis are full of doubts due to possible limitations on his life and that of his family. Despite this, the need for information is not always satisfied, presenting major deficiencies in communication with health professionals.
“The Consultation by Consultation” is a study carried out by ConArtritis that was born with the intention of understand the needs of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), juvenile idiopathic arthritis (JIA) and spinyloarthritis (AS)as well as those of the professionals who care for them.
During the process, depth interviews based on questionnaires previously worked on and endorsed. In addition, there were carried out surveys of professionals occupational therapy, physical training, psychology and nutrition who had a minimum of five years of experience and at least 60% of care activity in public health.
The main objective of studywhich has had the collaboration of the companies AbbVie, Janssen, Lilly, MSD and Pfizer is analyze existing gaps and propose solutions to improve these communication deficits, such as comprehensive care from a multidisciplinary team and, without a doubt, a better quality of care in rheumatology.
Diagnosis: a key moment for information
In recent years, care for patients with arthritis or spondyloarthritis has experienced a progressive evolution towards shared decision making.
On the one hand, the doctor must clearly explain the therapeutic options and on the other hand, the person must present their opinion. The ultimate goal is for the patient to takeAn informed decision according to your values and preferences, ensuring that these guide clinical decisions.
However, the study “The consultation by consultation” indicates that some of the people who have been surveyed affirm receive very little information by your doctor at the time of diagnosis.
Rheumatology specialists must provide quality care based on the best available evidence and an understanding of the values of the person with arthritis and spondyloarthritis.
Furthermore, they must cover all aspects of carefrom adequately informing about the diagnosis to generating a therapeutic objective and a personalized management plan.
Cover of the study “La Consulta a Consulta” by ConArtrítis.
Main conclusions of the study
To carry out this research, a total of 34 interviews were carried out, 20 with people with the disease, 8 with rheumatology specialists and 6 with nurses. A total of 11 questionnaires were sent, 2 to psychology specialists and 3 to each of the remaining specialties (occupational therapists, physical trainers and nutritionists).
From the results the following conclusions were drawn:
Surveys reveal that in the time of diagnosis The person with arthritis and spondyloarthritis has numerous doubts and questions and the information they receive from the health professional is scarce.
During treatment: People with arthritis and spondyloarthritis continue to express the lack of information they receive from their specialists: possible side effects, pain, follow-up… Dissatisfaction focuses, to a large extent, on the feeling that the doctor has not done enough research (or been receptive to listening) about the personal circumstances of the person with arthritis and spondyloarthritis, their way of life or their habits to understand the consequences that the disease will have in these aspects. They detect the difficulties that many specialists experience in properly managing dialogue with their patients. It’s not easy to know how to optimize the conversation.
Eleven improvements in communication for patients with arthritis
Promote empathetic communication. Establish training and education mechanisms. Consider the patient as a unique person. Offer clear and realistic information to help you lead your “new life.” Dedicate adequate time for consultation. Facilitate access to reliable sources of information. Provide information about treatments. Provide sufficient information about the possible adverse effects of the treatment and, above all, access to professionals to resolve doubts. Health resources from other specialties that your doctor can provide (occupational therapy, physiotherapy, psychology, etc.) Provide information materials and collection templates that help the person with arthritis and spondyloarthritis to identify and record the aspects to discuss in the next consultation . Optimize and educate about the teleconsultation format Analysis of a patient’s pulse. Image provided by ConArtritis.
Other areas to improve healthcare
occupational therapy
In the words of specialists, this discipline brings great satisfaction to people with these diseases. However, many of them have never received treatment
Occupational therapy prevents deformities, improves quality of life, enhances autonomy and
It can reduce the time on medical leave with a faster return to work life, thus freeing caregivers from burden.
Physical training
Experts who primarily treat middle-aged and older women with rheumatoid osteoarthritis
or spondyloarthritis, or young girls who are active and used to exercise.
Patients are rarely referred to them from rheumatology. They are usually people with arthritis and spondyloarthritis who already practiced a sport and want to continue practicing it in an adapted way without putting their health at risk, and also to improve their quality of life.
Psychology
They fundamentally treat symptoms such as anxiety, depression and the experience of pain. Referrals from the rheumatology service are scarce, rather they are given through patient associations or at the initiative of the patient themselves.
The benefit is very clear, with extensive scientific evidence that supports it, and 80% of them can receive
discharge upon achieving the objectives set in the first session.
Nutrition
These specialists treat cases of weight disorders, especially in women over 65 years old or with multiple pathologies and men between 50-60 years old. They normally come due to overweight problems that worsen their illness. Referrals from rheumatology are scarce.
In the case of people with rheumatoid arthritis, diet is closely linked to incorporating anti-inflammatory dietary habits. This strategy and dietary re-education, in addition to having extensive scientific evidence, demonstrate great benefit for these people.
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