Rheumatoid Arthritis: Which Patients Do Best?

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The Roles of Patient Knowledge and Motivation, Compliance, and Self-Management in Outcome

Health care is an evolving art-science. Long gone are the days when patients with chronic diseases simply arrive at a doctor's office and are told a diagnosis, given a prescription, and asked to return in so many weeks or months without any discussion or transmission of information about the pathophysiology of the illness, treatment options, prognosis, or methods of monitoring for drug toxicity. This is particularly true in the management of rheumatoid arthritis.

The optimal management of rheumatoid arthritis begins with patient education about how the disease occurs and what damage it can cause, as well as an overview of the symptoms, diagnosis, and treatment options. Consequently, there are major advantages for patients who have the capability of understanding a variety of new concepts and are motivated to participate in the treatment decisions and monitoring of both the rheumatoid disease and for potential toxicities of treatments.

Consistent with the concept of "better understanding of the illness leads to better outcomes," research studies have documented better outcomes for those patients with rheumatoid arthritis who come from higher socioeconomic backgrounds. It is felt that patients who are better educated about the rheumatoid condition are empowered to be more comfortable with confronting the various methods of treating and monitoring the disease. Moreover, they will be more motivated to monitor appropriately the consequences of treatments, such as being obligated to regularly test their blood to be confident that toxicities are detected early.

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