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Rheumatoid arthritis - Management
What is the role of primary care in the management of someone with confirmed rheumatoid arthritis?
- To be aware of local rheumatoid arthritis (RA) services and enable appropriate access to them. For example, to check the person has a named specialist nurse who coordinates care, and has access to physiotherapy and occupational therapy for advice on mobility, pain control, and work-related issues.
- To liaise with the person's specialist team, particularly in relation to changes in medication.
- To identify flares of RA, and manage these appropriately (see Management of an RA flare).
- To offer regular medication reviews, checking concordance and adverse effects (see the CKS topics on DMARDs and NSAIDs - prescribing issues).
- To identify, and manage where appropriate, any complications of RA or drug treatment. For example, dry eyes, anaemia, carpal tunnel syndrome, possible tendon ruptures, neck problems, respiratory problems, gastrointestinal problems, and the increased risk of infection and myeloproliferative disorders (see the CKS topics on Anaemia - iron deficiency, Carpal tunnel syndrome, Neck pain - cervical radiculopathy, and Haematological malignancy - suspected).
- To identify and manage any comorbidities related to RA or drug treatment. This includes:
- To offer pneumococcal and yearly influenza vaccinations, if necessary (see the CKS topics on Immunizations - pneumococcal and Immunizations - seasonal influenza).
- To assess the impact of RA on the person and their family (for example work, social life) and offer support.
- To assess for signs of low mood or depression (see the CKS topic on Depression).
- To improve the person's understanding of RA. For more information see the Arthritis Care, Arthritis Research UK, and National Rheumatoid Arthritis Society websites, and the arc patient information.
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