ORLANDO — Patients with rheumatologic diseases who are educated about the disease process and the pharmacodynamics of their treatments are more likely to continue to adhere to their therapies, according to a presentation at the Rheumatology Nurses Society Annual Conference.
“Nurses and physicians assistants really get to know their patients — I think even more than the physicians do — because we often know where they are at,” Amanda Mixon, PA-C, a physician assistant at Arthritis and Rheumatology Clinic of Northern Colorado, told attendees. “I will go into depth with patients — explain the T cells, B cells, the inflammatory cytokines — but I try to keep it as basic as I can, because, truth be told, that is how I think about it. Getting into the nitty-gritty of disease mechanics with a patient will get us both lost in the weeds.”
Mixon noted that health care providers should use individualize education to match the patient, confronting misconceptions as they arise, particularly in regard to disease mechanics, such as inflammation.
“When I discuss inflammation with my patients, many of them immediately think ‘inflammation is bad,’” Mixon said. “I try to correct that early on by explaining that inflammation is simply our body’s attempt at self-protection, to remove harmful stimuli and begin the healing process. Inflammation is good. We want inflammation; it’s just when you have too much of it, that’s when it becomes a problem.”
Patients with rheumatologic diseases who are educated about the disease process and the pharmacodynamics of their treatments are more likely to continue to adhere to therapies, according to Mixon.
She added, “When I am explaining diseases like rheumatoid arthritis, lupus, or multiple sclerosis, I put them in the context of having too much inflammation. When I’m talking with patients about the medications we prescribe, what I’m telling them is, ‘We want to suppress you. We want to lower that inflammation because we want to get you back into homeostasis. You’re producing too much, and anything too much is not a good thing’.”
According to Mixon, the patient’s understanding of the disease process is integral to improving medication adherence as it provides them with a level of empowerment against their disease.
“Patients want to understand the process, as I would want to understand if I was diagnosed with an autoimmune disease,” Mixon said. “I think when you more fully understand the disease, you feel more confident about whatever you have to do to stop it. When we discuss new medications, the first thing many patients respond with is ‘I’m going to get cancer’ or ‘The drug is going to kill me.’ However, if you outline the disease process and how the drugs work, then I think it’s much easier for patients to wrap their heads around why it is important to take their medicines and not stop their medicines.”– by Robert Stott
Mixon A. Fundamentals of immunology. Presented at: Rheumatology Nurses Society Annual Conference; Aug. 7-10, 2019; Orlando.
Disclosure: Mixon reports she serves on the speakers bureau for AbbVie, Celgene, Eli Lilly and Novartis, and is a consultant for AbbVie, Eli Lilly and Regeneron.