Tips for Setting Treatment Goals with the Patient

Dr. Ware suggests forming a support system, such as bringing family members along to appointments and investing them in the treatment process. Patients embarking on treatment plans can take advantage of available resources, including the ACR and the Arthritis Foundation’s websites, which offer support and advice.

Dr. Perl says it’s important to emphasize chronicity and to set realistic expectations to adapt to morbidities that affect daily living activities. “We encourage patients to learn as much as possible about their disease and to actively follow their medical records through a secure website,” he says. “We advise patients to share these records with other healthcare providers to secure a better level of care that involves co-morbidities outside the realm of rheumatology.”

The Importance of Goal Setting

When a patient has reached a decision about their goals for therapy, the specifics of the treatment choice become easier, Dr. Goodman says. Such goals as being pain free or not feeling fatigue are easy to assimilate into the treat-to-target approach. Longer-term goals can be incorporated as the patient feels better.

“Patients quickly appreciate the benefit and value of their input in assessing treatment progress. Visits are frequent when therapy begins to ensure the patient is progressing and tolerating the medication. Once patients realize that the questionnaires they complete prior to their visits are important data points in determining their response to therapy, and that these data points are then incorporated into decisions about changing treatment, they usually appreciate the ability to follow their response to therapy as they move toward the goals they have helped establish,” Dr. Goodman says. “Because of this standard of care, the collaborative process between a physician and patient becomes more fluid.”

Final Thoughts

When dealing with chronic diseases, achieving the ultimate goal—maintaining a life that’s as normal as possible—can be a lifelong journey. “People and diseases evolve over time, and treatment regimens need to evolve and change as well,” Dr. Ware says. “Goals are reset as diseases worsen or improve. New treatments become available that may dramatically change a patient’s disease control and ability to function.” Continuing conversations and modifying goals are ongoing.

Karen Appold is a medical writer in Pennsylvania.

Overcome Objections

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When discussing potential treatment options with pediatric patients and their guardians, Randy Q. Cron, MD, PhD, professor of pediatrics and medicine at the University of Alabama at Birmingham (UAB) and director of the Division of Pediatric Rheumatology at Children’s of Alabama, sometimes encounters families who are anti-Western medicine.