The quality of life of arthritis patients taking biologic arthritis medication

Abstract

The goal of the study was to explore and describe how arthritis patients experience the influence of arthritis on their quality of life after commencing with biologic arthritis medication. In order to achieve this goal, a qualitative research approach was adopted in an attempt to understand what the arthritis patients experience their quality of life to be while taking biologic arthritis medication. To achieve the research goal, the collective case study guided the research. Individual interviews, specifically semi-structured one-to-one interviews, with an interview schedule, were used as method of data collection. The researcher made use of Creswell’s (1998) qualitative data analysis process to analyse and to interpret the qualitative data. The trustworthiness of the data interpretation was confirmed through credibility, transferability, dependability and conformability. An analysis of the literature and transcripts of interviews was undertaken to answer the following research question: What is the influence of biologic arthritis medication on the quality of life of arthritis patients? The key findings of the study can be stipulated as follows: (1) Several signs and symptoms are associated with an arthritis patient, such as pain and fatigue; (2) Arthritis patients often visit several medical practitioners which can even be over a period of years before an official diagnosis of arthritis can be made; (3) A decrease of arthritis symptoms may be experienced during pregnancy, but increases again after the delivery; (4) Several types of arthritis treatments are available for managing the arthritis condition, ranging from traditional methods, such as anti-inflammatory medication, to biologic medication, such as Adalimumab (Humira); (5) A lack of knowledge pertaining to certain levels of medical doctors causes a mistrust amongst patients towards medical personnel; (6) Quality of life is a variable construct that is influenced by a patient’s culture and values; (7) Arthritis affects the patient’s ability to perform daily activities, such as washing; (8) Employment is important in making the patient feel human and therefore patients tend to hide their condition or to make adjustments at work, just to keep on working; (9) Biologic medication is seen as a miracle drug, albeit not totally without side effects, as patients are able to do things that were previously impossible; (10) Relationships are important in the life of an arthritis patient to enable coping, whether it be family, friends or the relationship with their medical practitioner; (11) Support provided by patients amongst themselves was also found to be important in order to facilitate coping with the disease; (12) Arthritis patients are encouraged to participate in physical exercise as it increases joint mobility; and lastly, (13) Biologic medication is quite expensive and patients are reliant on medical aids for funding of the treatment. In strengthening the role of social workers to assist arthritis patients to manage their disease better, the following recommendations are offered: (1) An awareness campaign facilitated by social workers, with experience in arthritic conditions, in collaboration with other health care workers in order to create awareness at different levels of society; (2) Social workers working in the field of arthritis should continuously strive toward improving the quality of life of arthritis patients they work with by setting up support networks and facilitating programmes that aim toward empowering those living with arthritis; (3) Social workers are encouraged to partner with rheumatology practices during which social workers are able to support newly diagnosed patients from the point of diagnosis. Social work support services could be in the form of counselling, or group support programmes; (4) A “fit for life” programme is recommended that is facilitated by social workers working with patients suffering from arthritic conditions with the goal of providing a safe environment where patients can be encouraged to be physically active. The aim will be to improve the patients’ quality of life experience, but also to create a safe environment for patients to support each other. (5) It is recommended that social workers working in the field of arthritis set up a database of patients that have proved to be involved in support programmes and shared their desire to provide guidance to newly diagnosed arthritis patients. The aim is then to partner a newly diagnosed arthritis patient with a more “senior” patient with a similar diagnosis and characteristics in order to establish a buddy support system. A context can then be created where the “senior” patient can share surviving techniques to the newly diagnosed patient but also provide assistance, for example picking up the children from school. Social workers are encouraged to then work closely with these buddies in order to provide further therapeutic support should it be required (6) Social workers working in the field of arthritis should always seek to advocate for arthritis patients when presenting at conferences and workshops (7) Investigate current, refine, or develop, policy related to the management and treatment of arthritis. Such policy should address aspects, including but not limited to, the employment conditions of people living with arthritis and securing the employment of people once diagnosed with the disease, medical aid and the requirements patients need to comply with in order to receive the full benefit provided to patients by medical aids, and thirdly, aspects related to the pricing (i.e., affordability) of disability insurance (8) The design and implementation of a continuous professional development programme is recommended to enable all health care workers to be continuously up to date with the latest developments related to arthritis research and management, in order to ensure that first line practitioners, for example physio-therapists and general practitioners, be equipped with the necessary skills to identify possible arthritis signs and symptoms which will ensure that patients are referred to specialist intervention as soon as possible. The sooner the patient receives the adequate level of care, the less joint deterioration may be sustained, and the higher the possibility to enjoy a good quality of life Future research could focus on initiating a research study that covers a more extensive geographical area, which is also more representative of the ethnic diversity in South Africa. Such a study could also cover more of the biologic medication used in the treatment of arthritis in order to reach a more holistic picture.