Preconception assessment is an essential component of pregnancy planning in sle. Systemic lupus erythematosus sle is an idiopathic autoimmune condition which has multi. Overall, the impact on adherence and disease outcome was inconsistent. Sle is a rheumatic disease belonging to the group of systemic autoimmune tissue diseases that affects primarily women of childbearing age female. It is about your strengths and potential as well as exploring useful resources that have helped you to manage your life so far. It is an auto insusceptible infection since the framework which advanced to ensure us from contaminations and conditions like tumor coordinates its. This information is provided for general education only. Guide the interview using a combination of open ended and closed ended questions. These autoantibodies cause inflammation, pain, and damage in various parts of the body. It is important that patients know the sideeffects of the medication and what these will do to alleviate their symptoms and or cure their diseases, as well as help. During this time, her antinuclear antibody remained positive at 180, her dnabinding activity varied from. There is no cure, but lupus and its symptoms can be managed with medication and. Sle is known to increase the risk of spontaneous miscarriage. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of.
Treatment includes antiinflammatory painkillers to ease joint pains. Presentation on the topic of patient counselling submitted by suman kumar b. Patient counseling is defined as providing medication information orally or in written form to the patients or their representatives on directions of use, advice on side effects, precautions, storage, diet and life style modifications. Yet, this issue has not been comprehensively explored, representing an important knowledge gap. Eugene tsang march 2008 similarly, do not jump to conclusions or rapid solutions without hearing all of the facts. Like kaysen, many people who attempt or commit suicide have ambivalent feelings about taking their own lives. A video of the previous years national competition finalists can be found on youtube and should be viewed in order to promote participation in the local competition. Health professions act hpa bylaws require a pharmacist to complete this step for every prescription, both new and refills. Pregnancy in systemic lupus erythematosus c c mok, rwswong abstract systemic lupus erythematosus sle is an autoimmune disease that predominantly avects women of reproductive age.
Evaluation of clinical pharmacist mediated education and. If there are no contraindications, patient should undergo preconception counseling, maternal and fetal risk assessment, and medication. As a group, sometimes the aging process affects certain elements of the communication process in some older adults. The patients blood pressure and urine analysis must be. Methotrexate is a folate antimetabolite that inhibits dna synthesis, repair, and cellular replication. Sle, autoimmune vasculitis, inflammatory bowel disease such as crohns disease, and other kidney or skin disorders. We suggest anticalcineurin therapy as alternative induction treatment.
The disease course can be sporadic and unpredictable but is typically characterised by periods of relapse and remission. Queries regarding the risk of disease flares during pregnancy, chance of fetal loss, and the safety of various drugs are often raised. Systemic lupus erythematosus is an autoimmune disease that affects many systems, including the skin, musculoskel. Lupus is a chronic condition that results from a malfunctioning immune system. Sle systemic lupus erythematosus symptoms and treatment. Definition patient counselling refers to the process of providing information, advice and assistance to help patients use their medications appropriately.
Individuals should consult a qualified health care provider for professional medical advice, diagnosis and. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. Diagnosis is based on both clinical manifestations and laboratory indices. Lupus is an autoimmune condition, meaning that your bodys immune system which normally protects the body from infection attacks your own tissues as though they were foreign. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. Kaysen called her boyfriend, giving him the opportunity to intervene. Most physicians are aware of the 11 revised classification criteria for sle of the american college of rheumatology acr. Existing data suggest that barriers to pregnancy counselling exist and might represent an area of need in order to optimize outcomes for sle pregnancies. Pdf patients with sle are often young females of childbearing age and a pregnancy wish in this patient group is common. Understanding and addressing patient needs sle has a considerable impact on patients, including their psychosocial wellbeing, interpersonal relationships, quality of life, productivity, and healthcare utilization. Over the long term hydroxychloroquine can reduce pain, swelling and joint stiffness.
The incidence and prevalence are difficult to establish, but surveys in north america and europe. The nature of physicianpatient interaction can have a significant impact on patient outcomes through informationsharing and diseasespecific education that can enhance patients active involvement in their care. Systemic lupus erythematosus sle is an autoimmune condition that has multiorgan involvement. Systemic therapy and counselling works in a respectful and resourceorientated manner. Systemic lupus erythematosus in children and adolescents. Needs and barriers to pregnancy counselling in women with sle. She improved over 4 weeks and then remained symptomfree for 5 years. Systemic lupus erythematosus and pregnancy in ireland. On the basis of these, a diagnosis of sle was made and the patient treated with aspirin for her painful knees. Intervention was undertaken in groups of up to eight patients and in two blocks over six months each. Systemic lupus erythematosus sle is an autoimmune disease that predominantly affects women of reproductive age. Pdf systemic lupus erythematosus is a systemic autoimmune disease with a. It provides general information to help you understand how you may be affected and what you can do to.
Patients with sle may present with various systemic. The most common type is systemic lupus erythematosus sle. Do not shift from one subject to another until each subject has been followed through. Systemic lupus erythematosus sle is one of the most common autoimmune disorders that affect women during their childbearing years. Lupus is an autoimmune disease, which means that the bodys immune system attacks the bodys own cells as if they were invaders like germs or cancer cells.
These classification criteria are not diagnostic criteria. It is also used to prevent transplant rejection in people who have received transplanted organs such as kidneys. The presence of ssa and ssb antibodies can lead to fetal heart block and. How to monitor sle in routine clinical practice annals. Improvement of coping abilities in patients with systemic. Problems with kidneys and other organs can occur in severe cases. Methotrexate irreversibly binds to and inhibits dihydrofolate reductase, inhibiting the formation of reduced folates, and thymidylate synthetase, resulting in inhibition of purine and thymidylic acid synthesis, thus interfering with dna. Hydroxychloroquine sideeffects, uses, time to work.
Systemic lupus erythematosus in pregnancy intricate, but. She presented with 1week history of productive cough, progressive dyspnoea together with prolonged fever, arthralgia, rashes and oral ulcers. Presentation of systemic lupus erythematosus sle in. This leads to inflammation and damage to body tissues, such as those in the joints, skin, kidneys, heart, lungs, blood. Systemic lupus erythematosus sle, is the most common type of lupus. Symptoms can be vague and vary between people, and therefore diagnosis can be difficult. Patient education and counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. Diagnosis, monitoring, and treatment of systemic lupus. Lupus erythematosus describes the typical rash of sle and the term systemic emphasises the potential for multiorgan involvement. Systemic lupus erythematosus sle or lupus influences around five million individuals worldwide. Pregnancy in systemic lupus erythematosus postgraduate. An online survey was used to assess whether sle patients would be willing to consider modifying their diet depending on their blood lipid levels. Sle is a systemic autoimmune disease whose clinical manifestations, course and.
It affects ladies more than men and affcets females between the age aggregate five to fifteen. If there are no contraindications, patient should undergo preconception counseling, maternal and fetal risk. Counselling of sle patients in tertiary care hospital original article 9 study materials the study material was developed in consultation with phy sicians, guide, clinical pharmacist and referring to the jour nals and standard textbooks which include as follows. Systemic lupus erythematosus also called sle or just lupus is a chronic disease that can affect various parts of the body. A guide for patients malaysian sle association lupus. Thus adequate preconception counselling must be provided by the rheumatologist during the initial visits for all women of childbearing age, and a more formal preconceptual fetal specialist is recommended when the patient expresses a. People with systemic lupus erythematosus sle were the participants in this study. In treating a sle patient, the doctor has to prevent flares, treat the flares, and minimise organ damage and complications. Systemic lupus erythematosus sle australasian society. Treating sle is often a team effort between the patient and several types of healthcare professionals namely, rheumatologists, nephrologists, haematologists, dermatologists, neurologists and psychiatrists.
According to usp, medication counseling is an approach that focuses on enhancing the problem solving skills of the patients for the purpose of improving or maintaining the quality of health. As sle can manifest in many different guises table 2, a thorough history and physical examination, including all major systems, must be undertaken at each clinic visit. Maternal and fetal complications of systemic lupus. Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances 5. As can be deduced from table 1, in the metaanalysis, 26% of sle patients experienced a flare of disease, which was in accordance with a 24% incidence in the promisse study. Childhoodonset sle csle is a rare disease with an incidence of 0. The spectrum of clinical manifestations, outcome and treatment of pericardial tamponade in patients with systemic lupus erythematosus. She had septicemic shock, respiratory failure requiring. Our objectives were to assess pregnancy counselling needs in women with sle and to identify. Assessment of patients with systemic lupus erythematosus. She survived, was able to get on with her life, and eventually wrote two novels and her memoir. An important consideration for physicians and women with sle is the risk of an sle flare. Rosenbaum e, krebs e, cohen m, tiliakos a, derk ct.
Systemic lupus erythematosus also called sle or lupus. Content introduction objective of patient counseling patient counseling contains communication skill barrier of patient counseling reference 3. It is approximately ten times more common in women than in men and is often diagnosed during the childbearing years. Pregnancy and its outcome is a major concern to most sle patients. Patients reported that there was a lack of clinical counselling regarding diet with only 24% of patients stating that their doctor had spoken to them about diet.
It may be as long as 12 weeks before you notice the benefits. To evaluate a novel specific psychological intervention aimed at improving coping in patients with systemic lupus erythematosus sle. A healthy diet is important in general, but perhaps even more so for the roughly 1 million americans and 3 million people worldwide who suffer from systemic lupus erythematosus sle. Lupus is also a disease of flares the symptoms worsen and the patient. Any new symptomssigns or changes in symptomssigns since the patients previous visit require further evaluation.
The journal seeks to explore and elucidate the educational, counseling and communication models in health care. In recent retrospective cohorts, sle flares were reported in. However, once diagnosed, a combination of prescribed treatment and lifestyle. In a limited number of patients, pregnancy may pose an unacceptably high maternal risk, justifying an advice to defer or avoid pregnancy table 1. Sle increases the risk of spontaneous abortion, intrauterine fetal death, preeclampsia, intrauterine growth retardation, and preterm birth. We reported a case of a young female patient presented with sepsis and diagnosed with melioidosis and systemic lupus erythematosus sle within the same admission.
Systemic lupus erythematosus sle, also known as lupus, is a disease of the immune system, which is estimated to affect more than 20,000 people in australia and new zealand. They need to be rigorously developed, consistent with the scientific literature, accessible, and implementable in practice 6, 7. Lupus is the short name for systemic lupus erythematosus sle. It can cause various symptoms, the most common being joint pains, skin rashes and tiredness. Systemic lupus erythematosus and melioidosis bmj case. Systemic lupus erythematosus sle is a heterogeneous, inflammatory, multisystem autoimmune disease in which antinuclear antibodies occur often years before clinical symptoms. Patient counselling should be available for all possible issues that may arise both for the individual with sle risk of disease flares and pregnancy complications and the foetus risk of neonatal lupus syndromes and learning difficulties. Evaluation of a multidisciplinary patient education. Lupus is the short name for the condition called systemic lupus erythematosus sle.
890 216 1220 272 1062 1437 1325 1441 1528 794 395 922 1529 283 124 1234 161 441 632 128 1373 1263 114 359 574 88 337 101 1185 1096 1175 1315 510 631 1064