Another key is to help patients understand their own emotional and mental reactions to their disease, including reasons that they don’t follow the prescribed regimen. “Maybe for some it’s financial,” Dr. Fields says, “but for many it’s psychological—fear of side effects, denial, or general stress is preventing them from doing something that has a very high benefit-to-risk ratio and can help them a lot, but they’re not doing it for psychological reasons.”
Batterman adds that “addressing the psychological and psychosocial needs of the patient contributes to adherence [and] is a very important concept. That helps in the management of the disease itself, but it really contributes to quality of life by providing disease management and coping skills. And that’s really our ultimate goal.”
Kimberly J. Retzlaff is a medical journalist based in Denver.
Support RA Research
Arthritis Foundation
- Ankylosing spondylitis (AS)
- Fibromyalgia (FMS)
- Gout
- Psoriatic arthritis
- Success strategies
- Systematic lupus erythematosus (SLE)
Cedars-Sinai
Hospital for Special Surgery
Informed Medical Decisions Foundation
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Patient Safety Foundation
References
- Ullman K. Chronic pain, the psychiatric perspective. The Rheumatologist. 2015 Jan;9(1):49–50.
- Wolfe F, Michaud K, Li T, et al. Chronic conditions and health problems in rheumatic diseases: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, systemic lupus erythematosus, and fibromyalgia. J Rheumatol. 2010 Feb;37(2):305–315.
- Zyrianova Y, Kelly BD, Gallagher C, et al. Depression and anxiety in rheumatoid arthritis: The role of perceived social support. Ir J Med Sci. 2006 Apr–Jun;175(2):32–36.
- Dickens C, Jackson J, Tomenson B, et al. Association of depression and rheumatoid arthritis. Psychosomatics. 2003 May–Jun;44(3):209–215.
- Dalgard F, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: A cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015 Apr;135(4):984–991.
- Schmid-Ott G, Schallmayer S, Calliess IT. Quality of life in patients with psoriasis and psoriasis arthritis with a special focus on stigmatization experience. Clin Dermatol. 2007 Nov–Dec;25(6):547–554.
- Rosen CF, Mussani F, Chandran V, Eder L, et al. Patients with psoriatic arthritis have worse quality of life than those with psoriasis alone. Rheumatology (Oxford). 2012 Mar;51(3):571–576.
- Ograczyk A, Miniszewska J, Kępska A, et al. Itch, disease coping strategies and quality of life in psoriasis patients. Postepy Dermatol Alergol. 2014 Oct;31(5):299–304.
- Measuring the impact of an early RA support and education program using a program evaluation with patient-identified outcomes. The 2014 ACR/ARHP Annual Meeting. 2014 Nov 19; Boston.
- Lisitsina TA, Vel’tishchev DIu, Krasnov VN, et al. [Clinical and pathogenetic relationships between immuno-inflammatory rheumatic diseases and psychic disorders] [Article in Russian]. Klin Med (Mosk). 2014;92(1):12–21.
- Jones E. Psychosocial aspects of rheumatic diseases. Can Fam Physician. 1990;36:991–993.
- Nota I, Drossaert CH, Taal E, et al. Patients’ considerations in the decision-making process of initiating disease-modifying anti-rheumatic drugs. Arthritis Care Res (Hoboken). 2014 Dec 10. doi: 10.1002/acr.22531. [Epub ahead of print]
- Nota I, Drossaert CH, Taal E, et al. Patient participation in decisions about disease modifying anti-rheumatic drugs: A cross-sectional survey. BMC Musculoskelet Disord. 2014 Oct 4;15:333. doi: 10.1186/1471-2474-15-333.
- Nyklíček I, Hoogwegt F, Westgeest T. Psychological distress across twelve months in patients with rheumatoid arthritis: The role of disease activity, disability, and mindfulness. J Psychosom Res. 2015 Feb; 78(2):162–167.