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Life with Arthritis Auto-immune Disease.

Clinicians role is important in promoting public health. Practically, nurses focus of their health promotion has been on Preventing disease and behavioural change of individuals with respect to their health. Thus, their role as health promoters is more complex, subsequently to their multi-disciplinary knowledge and experience of health promotion in their nursing practice.

What is Rheumatology medicine?

It is a branch of medicine that deals with investigations, diagnosis and management of patients with arthritis and other musculoskeletal conditions (MSK). It affects all ages, paediatric, young people, middle age  and old age.

What are the causes?

Unknown! Immune related, hence referred to autoimmune disease

Mixed connective tissue disease                                                    Regional pain syndome
Antiphospholipid syndrome                                                                 Non-articular pain syndrome

Carpal tunnel syndrome                                                              Tendonitis, Bursitis & Enthesopathies

Dermatomyositis                                                                           Neck Pain, Back Pain, Foot Pain

Dish

Fibromyagia

Giant cell Artheritis

Granulomatosis with Polyangitis

Myositis

Sjogren’s disease

Raynaud’s disease

Scleroderma

SLE

Vasculitis

 Management

Involves:-

  • Referral from Primary Health care
  • Investigations
  • Diagnosis
  • Drugs
  • Non-steroid anti-inflammatory drugs
  • Painkillers
  • Non – Biologic Disease-modifying anti rheumatic drugs (DMARDS)
  • Biologic Disease-modifying anti rheumatic drugs (DMARDS)

Tender and Swollen Joints 

The Early Arthritis Clinic

The early arthritis clinic aims to quickly assess, and if appropriate, start treatment for patients with suspected inflammatory arthritis (IA). According to NHS choice (2016), It is now identified that the best outcomes for rheumatoid arthritis (RA) are achieved when it is treated early. However, patients often do not show signs of classical rheumatoid arthritis in the early disease and may not have any pain.

This clinic will enhance rapid referral and increase the awareness of the need of patients presenting with the suspected inflammatory arthritis to be assessed early. These patients are offered treatment as early as possible, ideally in the ‘opportunistic window’ within four months of their symptoms starting.

Arthritis is a general term for approximately 100 diseases that produce either INFLAMMATION of connective tissues, particularly in joints, or noninflammatory degeneration of these tissues. The word means “joint inflammation,” but because other structures are also affected, the diseases are often called connective tissue diseases. The terms rheumatism and rheumatic diseases are also used. Causes of these disorders include immune-system reactions and the wear and tear of aging, while research indicates that the nervous system may often be equally involved. Rheumatoid arthritis can also produce inflammation in the membrane around the heart, lungs and white of the eye (Cush, Weinblatt, & Kavanaugh, 2010). Despite the cause of the illness not well-know, autoimmunity seems to play a crucial role in its progression and chronicity.

The public health strategy to apply according to Public health England document is chapter 8 (Ageing well) in early symptom of Arthritis diagnosis. Arthritis Research UK (2014), states 4 out of 5 people with rheumatoid arthritis have positive tests for rheumatoid factor, but about 1 in 20 people without rheumatoid arthritis also have positive results. Only about half of all people with rheumatoid arthritis have a positive rheumatoid factor when the disease starts. National Audit Office (2009), estimating that in England some 580,000 adults have rheumatoid arthritis, with around 26,000 new diagnoses each year. It was also estimated that rheumatoid arthritis costs the NHS around £560 million a year in healthcare costs, with the majority of this in the acute sector, and that the additional cost to the economy of sick leave and work-related disability is £1.8 billion a year (National Audit Office, 2009). Treatment of rheumatoid arthritis should be started as early as possible to minimise damage to joints, and the clinical consensus is that for treatment to be most effective, it should commence within three months of symptom onset.  Campaign such as Early Arthritis clinics has proven the positive impact awareness creating can have on early diagnosis of the disease.

Conclusively, Public Health England (PHE) (2014-2017), Highlighted the strategy for Arthritis as Once diagnosed, people with rheumatoid arthritis require: close management to maintain tight control of their disease, optimise treatment, and improve long-term prognoses; and education and support to enable them to come to terms with their diagnosis, and adjust to the impact the disease will have on their life, including their ability to work.

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