Pharmacists can promote safe use of meds for rheumatoid arthritis 

One to One

About 1.3 million adults in the United States have rheumatoid arthritis (RA), and about 75% of patients with RA are women, according to the American College of Rheumatology. Although no cure exists for RA, numerous medications are available to lessen symptoms and improve function. As members of the health care team and medication experts, pharmacists play a critical role communicating with a patient’s health care providers and helping patients optimize their medications.

Team-based care

“Medication safety is everyone’s responsibility,” said Lilly Pinto, Communications and Outreach Manager, National Association of Nurse Practitioners in Women’s Health (NPWH), in an interview with Pharmacy Today. “Once a treatment option has been chosen, it is up to the health care provider and pharmacist to establish that open communication and ensure that the patient has all the resources they need to take their medications safely and effectively,” she added. NPWH is represented on the National Council on Patient Information and Education’s (NCPIE) Board of Directors.

The key to better understanding patients with RA is “open communication,” noted Pinto. “When a patient’s health care provider shares patient information, the pharmacist will have a richer understanding of the treatment the patient needs, and now that the channels for open communication have been established, the pharmacist and health care provider will feel comfortable sharing follow-up information on a patient’s treatment,” Pinto said. 

To close the loop, pharmacists should communicate medication information back to the patient’s health care provider so the entire team stays informed about treatment decisions.

Treatment decisions

Treatment of RA includes using medications to achieve remission to prevent further joint damage and loss of function. However, one of the biggest therapeutic challenges is balancing the medication’s adverse effects with inflammation control.

Medications used to treat RA include NSAIDs, disease modifying antirheumatic drugs (DMARDs), glucocorticoids, and pain relievers.

Susan Rawlins, MS, WHNP-BC, NP, NPWH Director of Education, offered several medication safety tips for treating patients with RA. Rawlins advises pharmacists to communicate with prescribers when medication interactions are likely and to suggest possible alternative medications, such as when trimethoprim is prescribed to a patient who is taking methotrexate. 

“Pharmacists should educate patients about the importance of not using natural health products with known or suspected liver toxicity when taking methotrexate and DMARDs,” said Rawlins. “If the patient is using biologic DMARDs, remind them to talk to their prescriber before getting live vaccines such as herpes zoster.”

Pharmacists make a difference

As with many chronic diseases, medication adherence is critical to controlling RA symptoms. A pharmacist can play a major role in educating patients about medications to improve adherence and strengthen the relationship of the patient with the rheumatology team, wrote Carissa Flick, PharmD, and Jessica Farrell, PharmD, in a study published in the August 2013 issue of the Rheumatologist.

The authors noted that pharmacists can be used as a drug information resource. 

“Pharmacists are able to evaluate the literature and summarize it for the provider. A pharmacist can also document drug information in the medical record with proper references, or contact the patient directly to answer a medication-related question,” wrote Flick and Farrell.

The duo also suggested that pharmacists assist providers with choosing an appropriate therapy for a patient. “A pharmacist brings a different perspective and may be able to provide unique insight when choosing the right medication for a patient,” they wrote.

For more information about counseling patients about the benefits and risks of prescribed medications, visit NCPIE’s Talk Before You Take campaign. The website provides free downloadable talking points and tools to spark better communication about medications.