Pregnancy and rheumatoid arthritis

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Associate Professor Ilana Ackerman from SPHPM has published an editorial in Rheumatology highlighting the evidence and resource gap for women with rheumatoid arthritis (RA) who are planning a family.

RA is an autoimmune disease that causes pain and inflammation of the joints. Other parts of the body can also be affected. Inflammation causes the joints to become painful, hot and swollen and movement to be restricted. The disease has a significant personal and societal impact, in terms of disability, quality of life, work participation and healthcare costs. It is the second most common form of arthritis and affects nearly half a million Australians and an estimated 57% of people with RA are women.

For women in their reproductive years, living with RA presents a number of challenges relating to contraception, pregnancy, breastfeeding and early parenting and much of the educational resources for RA lack key information for women at this life stage.

In a study investigating the specific educational needs of women with RA who were recently pregnant, currently pregnant or were planning a pregnancy, many participants cited a lack of accessible and relevant information (particularly around the safety and toxicity of RA medications) and expressed a strong desire for practical strategies to assist them in meeting the daily challenges of caring for a young baby.

“Given the recent evidence around unmet educational needs and limited evidence for the effectiveness of educational interventions, it is clear that more needs to be done to support women with RA across the pregnancy and post-natal continuum,” Associate Professor Ackerman said.

In a recent systematic literature review, her team found that only one of 68 studies specifically evaluated pregnancy-focused education or self-management support for people with RA.

Associate Professor Ackerman and her collaborators have recently completed a national study designed to establish cross-discipline consensus on key messages that should be delivered to women with RA by health professionals regarding contraception, pregnancy, breastfeeding and early parenting.

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It is hoped that these messages will assist rheumatologists, obstetricians and clinical pharmacists in providing consistent pregnancy-related advice to women with RA and their families. There is also an important role for arthritis consumer organisations to act as resource hubs for women with RA and their treating health professionals.

“This is an exciting opportunity to develop and evaluate targeted resources encompassing medication-focused information and pragmatic peer knowledge and skills that are clearly sought by this patient group,” said Associate Professor Ackerman.

(Source: Monash University, Rheumatology)

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Date Created: May 10, 2016