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Getting the most out of your appointments

Appointments with your rheumatologist are a great opportunity for you to discuss your RA, both the improvements and problems you’ve experienced, as well as a chance to get the answers to any questions you may be having.

After all, your rheumatologist needs your input so that you can reach a shared decision on the treatment option that is most suitable for you1. The following checklist can be used to help you make sure you are prepared for your appointment and that you have all of the information you might need to hand.

You may also have questions that you would like to ask, but feel you can’t. The Unspoken questions can be used to help you address your concerns and ensure you get the answers you need.

Before your appointment

Download and start using the TRACK Diary

The TRACK Diary is a simple way to help you keep track of your medication, and help you record how you are feeling over time.

Think about what you would like to discuss with your rheumatologist

Considering what you want to ask your rheumatologist before you have your appointment can be a big help. Remember, it’s important you get ALL the information you need – especially the answers to those Unspoken questions that some people don’t want to ask.

Some suggested topics you may want to think about ahead of your appointment include:

  • How do I feel after I have taken my medications?
  • How have I been feeling recently?
  • Has my RA changed?
  • What improvements have I noticed?
  • What problems am I having?
  • Am I taking my medication as I should?

If you need to, you should make a list of the topics that you wish to discuss and take it with you. Take a look at the Unspoken questions to help you prepare for your appointment.

How is your RA?

Before you see your rheumatologist, it is a good idea to make sure you have fully considered what you want to discuss. This can be anything you want but may include; how you have been feeling, if your RA has progressed and how your treatment has affected your life. Remember, it is important to discuss all aspects of your RA and treatment, both the positives and anything that has been difficult for you recently.

Stopping smoking

Smoking has a negative effect on all aspects of health and quitting should always be encouraged. But did you know that heavy smoking has been linked with an increased risk of developing RA?2,3 Evidence also suggests that heavy smoking can lead to increased RA disease progression, severity and functional impairment4 and decreased response to treatment.5

If you want to quit smoking, talk to your doctor or pharmacist. They will be able to offer you advice and support to help maximise your chances of success.

At your appointment

Show your TRACK Diary

This will give them a fantastic insight into how your treatment is really going.

Make sure you ask all the questions you have

This is your chance to get the answers you need, so if you haven’t fully understood something don’t be afraid to ask your rheumatologist to explain it again.

Unspoken questions

Your rheumatologist wants to make sure you are receiving the most appropriate treatment for you, but they need your help when choosing your treatment; only you know how you feel. You should also ask questions to find out what you need to know; what benefits can you expect from your treatment, are any of the unwanted effects you may be feeling normal, are there any simpler treatment regimens? Although some questions may be difficult to ask, the insight they provide into your RA can be a big help to your rheumatologist. You may want to consider the following Unspoken questions to see if they apply to your experiences:

Questions about “Unwanted Effects”:
1. Are there any unwanted effects that people commonly experience with my medication(s)? Is what I am experiencing normal?

2. You may find it helpful to think about how you feel each day and note down feelings you think may be connected to your treatment plan; the TRACK Diary can help you to conveniently record this. This can give your rheumatologist a greater understanding of the severity of your problems and what may be causing them.

Questions about “Missing Medication”:
1. Recently, I have been tempted to miss / I have missed some of my doses because I haven’t been feeling very well. Is there anything we can do to make my treatment plan easier to stick to?

2. Sometimes I take less of my medication than I was prescribed, is this a problem?

3. After I take my medication, I sometimes feel tired/nauseous/…, is there anything I can do to reduce this?

4. My treatment can sometimes make me feel…, and it sometimes affects me day-to-day. Can I do anything to change this?

Questions about “Forgetting things”:
1. Sometimes I don’t remember all my doses. Is it possible for me to have a simpler treatment plan?

2. I sometimes forget to take my medication on the same day each week. Is this a problem?

Questions about “I just can’t do it”:
1. My treatment can make me feel ill and I’m not sure I want to continue with it, what options do I have?

2. My treatment makes me feel ill and it can be tough to do my day-to-day activities. What can I do?

Questions about “smoking”:
1. Is cigarette smoking associated with an increased risk of developing RA?

2. Can smoking affect the severity of my RA symptoms?

3. Does my smoking affect the efficacy of my RA medications? If I stop smoking, will my RA symptoms improve?

4. Will stopping smoking result in less side-effects from my RA medication?

After your appointment

If you have time, don’t leave straight away

Take a seat in the waiting room, or somewhere convenient, and record the details of your conversation with your rheumatologist in your TRACK Diary. This will help you to prepare for your next appointment and could be a useful reminder for your rheumatologist too.

Update your TRACK Diary

With any changes that were made to your treatment.

References

  1. Smolen JS et al. Ann Rheum Dis 2013; 73:492-509.
  2. Hutchinson D et al. Ann Rheum Dis 2001; 60:223-227.
  3. Johannsen A et al. Peridontology 2000 2014; 64(1):111-126.
  4. Másdóttir B et al. Rheumatology 2000; 39:1202-1205.
  5. Canhão H et al. Rheumatology (Oxford) 2012; 51(11):2020-2026.

The 'RA Unspoken campaign' is a collaborative project between Arthritis Care, Roche Products Ltd. and Chugai Pharma UK Ltd and is aimed at people with rheumatoid arthritis. The project has been initiated and funded by Roche Products Ltd. and Chugai Pharma UK Ltd.

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RCUKCOMM00179f(2) August 2014