Botnar Research Centre, NDORMS, University of Oxford, Oxford, UK
Transparency in Healthcare B.V, University of Twente, Hengelo, The Netherlands.
RMD Open. 2021 Dec;7(3). doi: 10.1136/rmdopen-2021-001959.
This expert opinion article explores the strategy of adopting a holistic approach to the management of rheumatoid arthritis (RA) by incorporating the wellness practices of exercise, optimised sleep, optimised nutrition, mindfulness, social connectedness and positive emotions into the management plan. The aim is to attain optimal health for each patient beyond that achievable by limiting disease management to pharmacological treatment to attain the lowest achievable composite scores of disease activity, as recommended with the current treat-to-target approach, and addressing the recent recognition of pain control as a key patient-reported outcome. Incorporating wellness practices into a busy clinical setting requires creativity and customisation based on the individual practice setting and the individual needs of each patient. Such practices can help people living with RA to achieve optimum wellness through the introduction of measures-according to individual need-designed to improve the aspects of life most impacted for that person, thereby complementing treat-to-target and pain control strategies with pharmacological agents. Clinicians must consider wellness practices in addition to treat-to-target pharmacological agents for the holistic management of people with RA.
这篇专家观点文章探讨了通过将锻炼、优化睡眠、优化营养、正念、社交联系和积极情绪等健康实践纳入管理计划，采用整体方法来管理类风湿关节炎（RA）的策略。其目的是通过将疾病管理限制在药物治疗上，以达到最低的疾病活动综合评分，从而实现每个患者的最佳健康，这是目前的达标治疗方法所推荐的，同时也满足了最近对疼痛控制作为关键患者报告结果的认识。在繁忙的临床环境中纳入健康实践需要根据个人的实践环境和每个患者的个体需求进行创造性和定制化。这些实践可以通过引入根据个人需求设计的措施，帮助 RA 患者改善对其个人影响最大的生活方面，从而通过药物治疗来补充达标治疗和疼痛控制策略，从而实现最佳的健康。临床医生在进行 RA 患者的整体管理时，必须考虑健康实践，而不仅仅是达标治疗的药物治疗。
