Collaborate for RA patient benefits

Achieving better outcomes for rheumatoid arthritis patients requires successful collaboration between specialists, GPs and pharmacists.

A new NPS MedicineWise education program has highlighted the importance of successful collaboration between rheumatologists, general practitioners (GPs) and community pharmacists in the early diagnosis and treatment of rheumatoid arthritis (RA).

Deirdre Criddle, Complex Care Coordinator/Pharmacist at CoNeCT – Complex Needs Coordination Team, told Australian Pharmacist that better collaboration and interdisciplinary care will ensure better health outcomes for people with RA.

‘Patients who have a good medical home are advantaged. By that I mean, they have good care around their medicines and medical management. A rheumatologist and a GP and a pharmacist who know the patient well can make sure that communication channels are kept open and operational,’ she explains.

‘I can tell you from working in complexity, it’s the patients who have fragmented care, and don’t have that good medical home, who don’t do well.’

The program, developed in partnership with the Australian Rheumatology Association and Arthritis Australia, reinforces that early investigation, diagnosis and treatment of RA can improve a patient’s physical function, delay or prevent irreversible joint damage, and increase their chance of clinical remission.

Its recommendations could have a big impact on how pharmacists think about their role in the early diagnosis and treatment of RA.
‘Two areas of impact would be on assisting in identifying patients with early arthritis through referral back to the GP, and providing education when methotrexate is started,’ said Ms Criddle.

Methotrexate – the gold standard RA treatment – has many misconceptions and fears associated with it, which can compromise the patient’s adherence. Unclear consumer medicine information can make these issues worse.

‘Consumer information commonly refers to cautions and potential toxicity concerns that apply to methotrexate when it is used in high doses in chemotherapy. These are not relevant to the much lower doses used to treat RA,’ explains Dr Andrew Boyden, Medical Advisor at NPS MedicineWise.

Pharmacists could work with GPs and rheumatologists to give patients consistent, clear messages about methotrexate and other medicines, to minimise their concerns and improve their medication adherence and health outcomes.

Pharmacists also would have a role in counselling patients about reducing lifestyle risk factors for RA and other associated health conditions, like cardiovascular disease.

‘Smoking is a risk factor for getting RA, but it also significantly adds to the risk of poor outcomes with cardiovascular risk.

‘Smoking is very high on the list of how pharmacists can have a crucial role in improving lifestyle,’ said Ms Criddle.

To access the educational program, visit