Rheumatology Advance Access originally published online on March 12, 2008
Rheumatology 2008 47(5):741; doi:10.1093/rheumatology/ken080
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Comment on: Is it ever appropriate to discharge patients with rheumatoid arthritis?
1The Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, 2Heberden Unit, Amersham General Hospital and 3ARMA, London, UK.
Correspondence to: P. Prouse, The Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK. E-mail: peter.prouse{at}bnhft.nhs.uk
SIR, the importance of appropriate standards of care for people with RA cannot be overstated. The Arthritis and Musculoskeletal Alliance (ARMA) welcomes the editorial of Drs Bukhari, Bamji and Deighton [1] and their implicit endorsement of the ARMA Standards of Care for People with Inflammatory Arthritis [2], standards that are patient focused and take into account the needs of patients throughout the course of their disease.
Evidence points to enormous variation in peoples’ experiences and in the quality of care they receive [3]. The ARMA standards also highlight the utmost importance of early intervention and tight control of disease activity when trying to achieve remission and prevent long-term disability [4].
Recent evidence demonstrates progressive deterioration in function and X-ray assessed joint damage for both those classified as having moderate disease as well as those classified as having severe disease [5, 6]. These findings further confirm the essential contribution of a skilled multidisciplinary team to the management of patients with RA throughout its course. Their input is important throughout the disease course as functional disability and pain have unfortunately been an inevitable consequence of disease duration [7]. The ARMA Standards of Care address the needs of the patient throughout the entirety of their disease.
While ARMA Standards of Care for inflammatory arthritis (IA) were developed with strong patient input, we fear that local and regional commissioning processes to provide services for patients with IA will not. We fear these processes will aim for short-term cost savings at the expense of a skilled multidisciplinary delivered service and will not take into account the long-term disabling nature of the condition with its ensuing costs.
Disclosure statement: The authors have declared no conflicts of interest.
 |
References |
|---|
 Top References |
|---|
- Bukhari M, Bamji AN, Deighton C. Is it ever appropriate to discharge patients with rheumatoid arthritis? Rheumatology (2007) 46:1631–3.
[Free Full Text] - Standards of Care for people with Inflammatory Arthritis. (2004) London: Arthritis and Musculoskeletal Alliance.
- Access to anti-TNF
therapies for adults with inflammatory arthritis. A report by the British Society of Rheumatology and the Arthritis and Musculoskeletal Alliance. (2005) www.rheumatology.org.uk. - Griger C, Capell H, Stirling A, et al. Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet (2004) 364:263–9.[CrossRef][Web of Science][Medline]
- Aletaha D, Smolen J, Ward M. Measuring function in rheumatoid arthritis. Arthritis Rheum (2006) 00:2784–92.
- Dixey J, Young A, Emmett C, et al. The relationship between function and radiological damage in early rheumatoid arthritis (RA) – a longitudinal analysis from the ERAS cohort. Arthritis Rheum (2007) 56(Suppl):S173.
- Scott DL, Pugner K, Kaarela K, et al. The links between joint damage and disability in rheumatoid arthritis. Rheumatology (2000) 39:122–32.
[Abstract/Free Full Text]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||