Challenges and solutions to the psychosocial management of chronic pain in rheumatoid arthritis patients
For managing pain in rheumatoid arthritis (RA) patients, the psychological therapy has stood out well according to a number of reviews and meta-analyses.
Thus, the literature has been put forward to answer the further questions like: 1) what modalities are best for conducting the intervention 2) do different patients avail from different approaches 3) what sort of interventions are most strongly supported by the current evidence 4) when is it more suited to intervene 5) what model of care should we be proposing that will result in ubiquitous implementation and will assure access for patients with RA.
According to this review, for pain management in RA patients, cognitive behavioral therapy (CBT) is the most effective treatment when employed early at the onset of disease. But, in the patients with a history of depression evidences support that mindfulness may prove to be beneficial. Currently, in the people suffering from comorbid psychological disorders, only handful evidences support whether psychosocial interventions are effective or not. With a view to avoid physical and psychological morbidity, one of the main concern is ensuring access to effective intrusion for the initial stage patients. A stepped-care model is recommended, but there is a desperate urge for more, good quality trials of minimal interventions, specially in Internet-delivered CBT. It wpuld appear propitious and may develop a bedrock of future stepped-care models for providing psychosocial care to RA patients