Supporting young adults with psoriatic arthritis.

Psoriatic arthritis (PsA) is associated with psoriasis, a chronic inflammatory skin disease. About 30% of patients with psoriasis develop PsA, and some of these patients are children and young adults. Because onset can be gradual, PsA signs and symptoms are easily attributed to other causes, especially in younger patients. This article discusses the assessment, pathophysiology, and diagnosis of PsA and informs nurses how best to support patients with PsA.

2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis.

To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse's role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.

Psoriasis & psoriatic therapies.

Psoriasis is a chronic inflammatory disease primarily affecting the skin. This article discusses the presentation, epidemiology, and pathogenesis of psoriasis as well as a brief consideration of psoriatic arthritis. Psoriasis treatment options include topical agents, phototherapy, conventional systemic therapies, and biologics.

Benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis: A systematic literature review.

The aim of this study was to systematically review the literature available about the benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis in the framework of the drawing up of the axial spondyloarthritis and psoriatic arthritis guidelines of the "Spanish Society of Rheumatology". Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, Medline/PubMed, CINAHL) were systematically searched from inception to 2014 using medical subject headings and keywords. Only articles in English, Spanish and French were included. The patients studied had to be diagnosed of psoriatic arthritis (all ages, both sexes) with axial involvement and/or peripheral arthritis who had received health education by a specialized nurse. We included in the search randomized clinical trials, cohort observational studies, descriptive studies and case series and qualitative research studies. Measured outcomes were those related to the education provided in a nursing consultation such as increased adherence to biological therapy, conducting exercises, smoking cessation and patient satisfaction. Eight studies were included, five randomized clinical trials with moderate level of quality and three intervention studies with no control group with low level of quality. Meta-analyses were not undertaken due to clinical heterogeneity. According to our results, it can be concluded that although there is little evidence on the role of a trained nurse in patients with psoriatic arthritis, this role can be beneficial to the patients because it can increase the rate of adherence to treatment prescribed by a rheumatologist, promotes patient self-management of their disease and increases patient satisfaction.

Management of patients with psoriatic arthritis.

Psoriatic arthritis is a chronic inflammatory arthritis condition. If left untreated, patients with psoriatic arthritis may suffer pain, reduced quality of life, joint damage, and disability. Understanding clinical presentation and comorbidities of the disease, as well as current guidelines for treatment, allows the nurse practitioner to provide comprehensive care for patients.

Early psoriatic arthritis: facing the challenge.

Early diagnosis and initiation of therapy has become a primary objective in clinical rheumatology. As psoriatic arthritis causes deformities and joint damage leading to impaired quality of life and function as well as increased mortality risk, there was an urgent call for action aiming at inducing remission of the active inflammatory process. Until the year 2000 there were no treatments that led to a reduction in progression of joint damage. However, with the advent of anti-tumour necrosis factor agents, it is now possible to arrest the progression of damage in these patients. Therefore, the concept of window of opportunity, that is early assessment and management in specialist clinics, has been extended to psoriatic arthritis with successful outcomes among psoriatic arthritis patients similar to those with rheumatoid arthritis. Although all this sounds plausible, early psoriatic arthritis assessment remains limited to research as setting up this type of service in standard clinical practice faces several challenges that would need tackling. The objective of this article is to provide an overview of these challenges and suggest a paradigm for use in standard clinical practice to identify early psoriatic arthritis patients.

Care and support of patients with psoriatic arthritis.

Psoriatic arthritis is an inflammatory disease of the joints associated with progressive joint destruction and loss of function. The additional challenge of managing psoriasis can mean patients' needs differ from those associated with other inflammatory joint conditions. This article discusses the goals of drug treatment and physical therapies in terms of minimising symptoms of the disease. In addition, the psychological effect of this physically debilitating and unpredictable disease is explored. Guidance is offered on how the nurse should address the individual needs of patients and the importance of regular monitoring to ensure safety and efficacy of treatments. The need for effective patient education is emphasised to ensure the person is better able to manage disease progression and any treatment regimens. The nurse's role should be viewed in the context of the multidisciplinary team to ensure all patient needs are met.

Managing inflammatory arthritides: Role of the nurse practitioner and physician assistant.

PURPOSE: To review the current management of the inflammatory arthritides, including rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. This review examines the role of the nurse practitioner (NP) and physician assistant (PA) in the management of these chronic diseases. DATA SOURCES: A review of the scientific literature and current guidelines regarding the management of inflammatory arthritides. CONCLUSIONS: NPs and PAs play important roles in the interdisciplinary team involved in the treatment of patients with chronic inflammatory arthritic conditions. The management of inflammatory arthritides has evolved with the development of new treatment strategies and is focused on early intervention and minimizing progressive joint damage. NPs and PAs are ideally positioned to educate patients regarding treatment options and other important aspects of the disease process and to monitor disease activity using a number of validated instruments. IMPLICATIONS FOR PRACTICE: Through active disease management, NPs and PAs can influence their patients to make better, more informed choices regarding treatment, which may optimize patient outcomes.

Psoriatic arthritis: a guide for dermatology nurses.

Psoriatic arthritis (PsA) affects people in the prime of life, causing functional impairment and diminished quality of life. Etanercept, the first FDA-approved therapy, and other immunobiologics, offer hope for favorable long-term outcomes. It is imperative that dermatology nurses learn more about the basic immunology of psoriasis and PsA and the role of immunomodulation in their treatments.