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Autoimmunity Patient Management

Autoimmune Diseases (AD) have established themselves as some of the leading non-communicable diseases across the globe. While science has progressed, and given us a deeper understanding of these sometimes frustrating and elusive diseases, medicine is somewhat lagging behind. Because ADs cannot be cured, it may help to shift your mindset from “treatment” to “management.” It is even important to remember that managing ADs is often a lifelong process; full remission, which is often spontaneous, can be achieved for very few autoimmune diseases.1 Bearing this in mind, improved quality of life and a reduction in symptoms should be the definition of success for any management plan.

To achieve that success, healthcare providers will often use immunosuppressants or targeted therapies along with the basic principles of long-term personalized care. Because the presentation of ADs in each person is different, so, too, will be the approach you take to manage them. While this may require some trial and error, testing can help you identify the pathology and diseases that are occurring, which can help you refine the management plan.

It is not uncommon for patients to be overwhelmed or frustrated during this process. The chronic and incurable nature of AD can be daunting. The relationship and rapport you build with your patients can ease their minds, help them cope day-to-day, and facilitate open communication, which can help you create a more effective management plan.

A Different Approach - Tailored Management for Every Patient

Though science and medicine are growing in their understanding of ADs and how to manage them, healthcare providers are left to apply the management techniques used in other disease states like infectious disease, oncology, metabolic diseases, and transplantation.1 These approaches are not specific to the symptom presentation and etiology or pathology occurring with ADs. When combined with the intrinsic variability of ADs, it becomes necessary to adopt a case-by-case approach to disease management.

Treatment protocols must be managed and assigned according to each patient’s specific manifestations, biomarkers, and other immunological markers in a step-by-step process. The effort it takes to create a personalized management plan may lead to significantly improved outcomes and heightened hope for possible remission for patients with AD.

A systematic approach to design a personalized treatment for your patient’s AD is the best hope for remission, which has been well documented in several ADs.1

Communication is Key

As a clinician, it can be difficult to manage through the trial-and-error approach that is needed to find the most effective treatment plan for your patient. It can also be hard for patients to endure this process. Dissatisfaction with treatment can lead to poor adherence and, as a consequence, suboptimal health outcomes.

It is especially important to communicate to your patients the possibility that several therapies may need to be attempted before results are achieved. Setting expectations can help quell the doubts or frustrations that may lead to diminished adherence.

continued monitoring

Continued Monitoring

Once an effective management plan is established, it is important to continue to follow up with patients. Long-term follow up may include monitoring for the signs and symptoms that may indicate disease recurrence or progression, or the presence of additional autoimmune diseases.2

Cross screening with additional testing may help you gain awareness of coexisting diseases, which can help you further tailor your management strategy.

Could your patient be suffering from more than one disease?

References
  1. Chandrashekara S. The treatment strategies of autoimmune disease may need a different approach from conventional protocol: A review. Indian J Pharmacol. 2012;44(6):665-671.
  2. Williams A, Manias E, Walker R. Interventions to improve medication adherence in people with multiple chronic conditions: a systematic review. J Adv Nurs. 2008;63(2):132-143.