Comparative Study on the Extent of Damage to Life Quality in Rheumatoid Arthritis Patients with Different Therapeutic Strategies

Rheumathoid Arthritis affects more that 17.6 million of people worldwide [1]. Along with the diagnosis of Rheumatoid Arthrits (RA) comes a big change in patients life. The aim of this study was to evaluate the impact of disease stage or evolution on the patients quality of life, comparing 4 different therapeutic strategies, pursuing HAQ score and VAS (visual analogue pain scale).

A atenção domiciliar no cuidado ao cliente com artrite reumatóide/The home care at customer care with Rheumatoid Arthrits

O presente estudo relata o atendimento a uma usuária com o diagnóstico de Artrite Reumatoide (AR) e as intervenções terapêuticas ocupacionais desenvolvidas por acadêmicos do curso de Terapia Ocupacional da Universidade Federal de Santa Maria, buscando explanar as potencialidades do contato entre cliente e acadêmico. As práticas foram realizadas por meio de visitas domiciliares, em parceira com uma unidade de saúde do município de Santa Maria, RS. No desenvolvimento das ações, houve a escuta das demandas da cliente e de sua família, sendo as principais: a necessidade de orientações para a realização de transferência e as dificuldades do uso da cadeira de banho. Desse modo, foi elaborado um plano de tratamento que engloba intervenções e atividades que nortearam os atendimentos. Foi observado, a partir dessa vivência, o fortalecimento de uma rede de assistência à saúde, constituída entre Estratégia de Saúde da Família e Universidade, fato que favoreceu o cuidado e a qualidade de vida do sujeito acompanhado. A realidade em que a usuária estava inserida foi considerada durante todo o desenvolvimento das ações. Portanto, a construção do conhecimento advindo das atividades práticas favoreceu a criação de um pensamento reflexivo e um saber significativo.AbstractThis study was to describe interventions performed by academics of the Occupational Therapy course of the Federal University of Santa Maria, seeking to explain the potential of the contact between client and academic. The practices were held in partnership with the health unit in the county of Santa Maria, RS, through home visits. The study reports the attendance to the female user with a diagnosis of Rheumatoid Arthritis (RA) and developed occupational therapeutic interventions. There was the listening to the customer's demands and his family; the main ones being, the need for: guidelines for carrying out the transfer and the difficulties of using the shower chair. Thus, was elaborated a treatment plan containing measures and activities that guided the sessions. It was observed from the practices, the strengthening of a health care network, composed of the Family Health Strategy and Academy; wich favored the care and quality of life of the subject. The reality in which the user was inserted was responsible for guiding actions. Therefore, the construction of knowledge from practical activities made students create reflective thinking and meaningful learning.Keywords: Family Health Strategy; Home Visit; Occupational therapy.

Cost-effectiveness analysis of tocilizumab in combination with methotrexate for rheumatoid arthritis: A Markov model based on data from Serbia, country in socioeconomic transition

Background/Aim. Recent studies have shown that biological treatments for rheumatoid arthritis can change the course of rheumatoid arthritis and improve functional ability of patients with rheumatoid arthritis. In spite of this fact, use of biological therapy is still limited by high prices of these medicines, especially in countries in socioeconomic transition. The aim of our study was to compare costeffectiveness of a combination of tocilizumab and methotrexate with methotrexate alone for rheumatoid arthritis in Serbia, a country in socioeconomic transition. Methods. For the purpose of our study we designed a Markov model using data on therapy efficacy from the available literature, and data on the costs of health states calculated from records of actual patients treated in the Clinical Center Kragujevac, Serbia. The duration of one cycle in our model was set at one month, and the time horizon was 480 months (40 years). The study was done from the social perspective, and all the costs and outcomes were discounted for 3% per year. Results. Treating rheumatoid arthritis with diseasemodifying antirheumatic drugs (DMARDs) alone was more cost-effective in comparison with a combination of biologic treatment with tocilizumab and DMARDs. The total costs for treating a patient with DMARDs for one year were on average 261,945.42 RSD, or 2,497.70 Euro and the total costs for treatment with tocilizimab plus DMARDs were on average 1,959,217.44 RSD, or 18,659.20 Euro. However, these results are susceptible to changes in costs and treatment effects of tocilizumab in patients with more severe forms of rheumatoid arthritis. Conclusion. Our results show that the use of tocilizumab for rheumatoid arthrits in economic environment of Serbia is not cost-effective. Use of tocilizumab for treating rheumatoid arthritis can become affordable, if costs of its use become lower. In order to start using expensive biologic medicines in patients in transitional countries, special strategy and pricing policy of international pharmaceutical companies are necessary, which would include calculation of prices of biologic medicines on the basis of local pharmacoeconomic studies.