Ask the Pharmacist: Managing Arthritis
One in six – or about 50 million Americans – have been diagnosed with one of the seven common forms of arthritis. For patients and caregivers, understanding the potential impact of the disease on lifestyle and how best to manage it can be a critical part of making decisions that ensure better health outcomes.
The specially trained pharmacists in the Express Scripts Rheumatoid Arthritis and Inflammatory Disease Therapeutic Resource Center®, offered through Accredo, can help. These specialists with disease-specific expertise spend the majority of their time counseling patients with these conditions and can answer common – and uncommon – questions about how to manage the condition.
Understanding the Disease
Arthritis is a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions. Although common belief is that arthritis is a condition affecting the elderly, two-thirds of people with arthritis are under the age of 65, including 300,000 children. Arthritis affects people of all ethnicities.
The most common forms of arthritis, osteoarthritis (OA), rheumatoid arthritis (RA) and juvenile arthritis (JA), account for about 58% of all patients.
About 27 million Americans have OA, which is characterized by a breakdown of joint cartilage. A vast majority of OA patients are elderly.
RA is characterized by inflammation of the membranes lining the joint. Although it can strike at any age, women are typically diagnosed between the ages of 30 and 60, while male patients are usually older. There are about 1.5 million affected individuals in the U.S.
JA is a term used to describe many autoimmune and inflammatory conditions that can affect children ages 16 and younger.
The disease takes a heavy toll. Each year, arthritis accounts for 44 million outpatient visits and over 900,000 hospitalizations. In fact, it’s the leading cause of disability in the U.S and is a more frequent cause of activity limitations than heart disease, cancer or diabetes. By some estimates, 67 million Americans will have arthritis by 2030.
Managing the Disease
Managing the disease so that patients can continue to live normal lives is important. Each patient is different, and a physician can help determine the best treatment plan, including pain management and managing the symptoms of arthritis.
Here are some common tips I offer patients:
Exercise is a valuable tool in the fight against arthritis. OA and RA patients particularly can benefit from both endurance and resistance training.
Maintaining a healthy weight and protecting against joint injury can help prevent OA. Every pound of weight lost reduces the pressure on each knee by 4 pounds. Even small weight loss can be a big help in fighting OA.
There are many drug therapies available for arthritis patients – and doctors and specialist pharmacists can help identify the best one.
For patients who already are on medication to treat the condition, adherence – taking medications as prescribed by the doctor – is critical to healthier outcomes.
Here are a few medication-related tips I share with my patients:
Do not self-medicate: Combining over-the-counter medications with prescription medications can be risky and can cause side effects such as an increase in gastrointestinal irritation or a gastrointestinal bleed. Check with a doctor or specialist pharmacist before adjusting doses or making changes to the medication regimen.
Watch for drug interactions: Some common medications such as acetaminophen can have a drug-drug interaction with arthritis medications. Limit intake and remember that it is often a component in common sinus, cough/cold and pain medications.
Eat right: Some foods and beverages can block the effects of arthritis medications. These include grapefruit, apple and orange juice as well as milk and yogurt. Wait at least four hours after taking medications. Exact times can vary depending on the disease and the treatment. Check with a trained clinician.