Page 68 - Retail Pharmacy Magazine October 2020

66 HEALTH BONES AND JOINTS FROM PAGE 65 She says people with osteoarthritis usually have comorbidities, with high blood pressure being one of the most common. This, she says, can be combatted through general good health and physical fitness. “And general good health is intrinsically tied in with diet,” Ms Marine said. “There’s not a lot of evidence that shows that eating a particular food is good or bad for a patient, but certainly it appears that the Mediterranean diet can help those with arthritis and for general good health.” Mental health considerations Ms Marine says it’s of utmost significance that people with arthritis look after their mental health to avoid the chronic pain spiral – a person in pain becoming less active, which makes them gain weight and feel bad. This then results in depression, which makes their pain feel worse, and a vicious cycle ensues. The data, she says, shows that people with RA are more likely to suffer from anxiety, depression and low self-esteem. The condition can affect a person’s ability to participate in work, hobbies and social and daily activities. Combined with the chronic pain associated with RA, this can lead to mental health issues including depression, anxiety, feelings of helplessness and poor self-esteem. Such a scenario has resulted in people aged 45 and over with RA being 2.5 times likelier to describe very high levels of psychological distress compared with those without the condition, Ms Marine says. People with RA often have other chronic conditions, or comorbidities. According to self-reported data from the ABS National Health Survey 2017-18, 33 per cent of RA patients interviewed had mental and behavioural conditions, compared with 21 per cent of those without RA, and 22 per cent (versus 11 per cent) had heart, stroke and vascular disease. “Looking after mental health refers to doing enjoyable things, learning to pace themselves, and learning what level of activity is good for them, because too much or too little can impact adversely,” Ms Marine said. “It really depends on where people are at. While some only have mild osteoarthritis, as an example, others struggle with intense pain and limited mobility.” Joint replacement Joint replacement is an option for those who have severe arthritis, and can be very effective, but physical activity, exercise and weight loss can still be beneficial at this stage, Ms Marine says. “Exercise falls into conservative management techniques, and studies show that a large proportion of patients who are offered a conservative management program can delay surgery and sometimes don’t need to proceed to surgery at all,” she said. “It’s especially in this regard that the whole wear-and-tear paradigm of osteoarthritis has been counterproductive. “This message about the benefits of exercise for osteoarthritis has to really be emphasised, because it’s not getting out nearly as broadly as is required, although some inroads have been made.” She says success often hinges on the patient receiving tailored physiotherapy support as well as specific exercises to deal with the affected joints. Telehealth does the trick Ms Marine highlights that during the pandemic telehealth has been of great benefit to patients dealing with arthritis, especially having pharmaceuticals delivered to their home. TO PAGE 68 RETAIL PHARMACY • OCT 2020