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Need to address co-morbidities in rheumatoid arthritis patients

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The Government has been urged to take urgent action to improve management for rheumatoid arthritis patient after a report has revealed 80% of people with rheumatoid arthritis suffer from one or more co-morbidity.

At a summit on rheumatoid arthritis at the Houses of Parliament, the National Rheumatoid Arthritis Society (NRAS) launched its findings on 'The Impact of Rheumatoid Arthritis Co-morbidities'.

The report identifies that those with rheumatoid arthritis (RA) (690,000 people in the UK) are twice as likely to suffer from cardiovascular disease, COPD and infections; three times as likely to have anaemia; and are at greater risk of congestive heart failure, atrial fibrillation, vasculitis, strokes, interstitial lung disease, depression, orthopaedic problems, Sjogren's Syndrome and other diseases of the eye.

Those with RA are at increased risk over the general population of getting some types of cancer. In total, 80% of people with RA will suffer from one or more co-morbidity during their lifetime, as well as their RA.

The report makes 10 recommendations that will help patients and healthcare professionals to better manage RA related co-morbidities and also reduce the financial burden on the NHS.

Key recommendations include the implementation of the NICE clinical guideline which states that all patients should be offered annual care plans and holistic annual reviews which include measuring for co-morbidities and have access to a consultant led multidisciplinary team, and that the Information Prescription for RA patients is radically overhauled.

The National Audit Office Report (2009) found that direct NHS healthcare costs in England for RA are around £560m per year with the wider economic impact estimated to be between £3.8 to £4.8 billion a year. RA patients with co-morbidities receive care that is funded by NHS budgets that cover musculoskeletal, cardiovascular and cancer services, receiving care (via other departments) from a total spending pot of over £13.11 billion a year.

The report shows that significant savings can be made through giving earlier access to the full multidisciplinary team, offering better patient information and promoting better self-management.

Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said: 'The government needs to take urgent action to improve management for RA patients and raise awareness of the co-morbidities linked to RA. Patients have the ability to manage the risk factors more proactively but if they do not know about cardiovascular and osteoporotic risks, they are far less likely to address factors such as smoking, weight and diet which are firmly within their control.'

The government has made clear its commitment to supporting greater self-management for people with long-term conditions, and the development of a specific self-management strand within the Quality, Innovation, Productivity and Prevention (QIPP) programme, which is aiming to make efficiency savings in the NHS of £20 billion by 2014-15 by providing more innovative, joined-up and high quality care.

Through implementing the ten recommendations, NRAS believes this will lead to greater awareness of the consequences of RA among all parties, encouraging better management and a coordinated approach by policymakers to tackle it. This will help contribute towards the target of achieving £20 billion of efficiency savings in the QIPP programme and has been recognised by the coalition government.

Early detection and treatment of RA and its co-morbidities can reduce their impacts and enable patients to take greater steps to self manage and take preventative measures in regard to co-morbid conditions such as heart disease, as well as enabling better targeting of existing financial resources.

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