“This study emphasizes that some patients are at risk of poorly managing their biologic therapy. These patients should be identified and monitored to avoid major and perhaps life-threatening complications,” Dr. Rat says.
Rheumatologists and their staff may need to remind patients more frequently about some of the misuse risks, Dr. Rat cautions.
Rheumatologists should remind patients to have patience with biologics in terms of allowing for effectiveness, managing side effects, and getting over the fear of self-injection, Dr. Askanase says.
5 Tips to Improve the Patient Education Discussion
1. Ask patients to bring a family member or friend with them, Dr. Troum advises. This gives the patient—who likely is still processing information about their disease—an objective person who will listen and ask questions regarding biologics. When a patient comes to the office alone initially, this sometimes means they must return for a second appointment to bring their companion. Dr. Troum is fine with this if it means they will be better informed about biologics.
2. Update your approach as needed. Dr. Huston finds that focusing too much on the risks of biologics scares patients away and that a balanced discussion of benefits and risks is typically needed. He also finds that patients often have preconceived notions about the medication and need their misinformation corrected. He alters his discussion based on perceived patient fears and preferences. “Some patients express a lot of anxiety and want to review biologic therapy in great detail, and others just say, ‘Whatever you think is best, doc,’” Dr. Huston says.
You may also change your education depending on patients’ lifestyle issues and financial challenges, Dr. Field says.
3. Tap into seasoned patients as resources for new patients. “Developing a ‘network’ can be a game-changer for my patients,” Dr. Field says. “We have our experienced patients available for support to our newly diagnosed patients. Patients considering biologics can tour our infusion suite and are encouraged to chat with patients who are receiving infusion therapy at that very moment,” Dr. Field says. “Many patients develop friendships that are quite helpful through their RA treatment journey.”
4. Think about new, useful ways to present medication information. In addition to the usual discussion and written material, the U.S. National Library of Medicine suggests several other teaching tools, including podcasts, YouTube or other videos, PowerPoint presentations, posters or charts, models or props, group classes and trained peer educators.
“Appropriate, effective patient education really requires a multidisciplinary and integrative approach using several modalities,” Ms. Batterman says. For example, support and education programs offer an opportunity to obtain support from peers who understand the complex concerns of fellow patients, with the benefit of healthcare professionals gently guiding the discussion. Nurses can provide further clarification and answer questions; social workers can assess and further explore issues around coping with chronic illness and treatment, which can impact patients’ understanding, decisions and adherence in a profound way.