Annual Review in Rheumatoid Arthritis
Introduction by Ailsa Bosworth, NRAS National Patient Champion
What’s one of those I can hear people asking! Well, in the NICE RA Guidelines which were published in February 2009, one of the recommendations was people with RA be offered an ‘holistic’ annual review which should encompass the following elements:
- assess disease activity and damage, and measure functional ability (using, for example, the Health Assessment Questionnaire [HAQ])
- check for the development of comorbidities, such as hypertension, ischaemic heart disease, osteoporosis and depression
- assess symptoms that suggest complications, such as vasculitis and disease of the cervical spine, lung or eyes
- organise appropriate cross referral within the multidisciplinary team
- assess the need for referral for surgery (see section 1.6)
- assess the effect the disease is having on a person's life.
The guideline is not mandatory, sadly, and therefore rheumatology units can choose whether to follow the guidance, or not, or to attempt to achieve some of it. Some units have made more progress than others in implementing the elements of the guideline and the Freeman Hospital in Newcastle is one such unit and the following article describes what they’ve done, how they have achieved it and what their patients think about it. If you are not having an annual review which encompasses much of the above, can we suggest that you ask your team if they are planning to implement holistic annual reviews in line with NICE guidance any time soon?
Ailsa Bosworth, CEO
By Dr Martin Lee
Taken from NRAS Magazine: Spring 2014