The Multidisciplinary Team
The Multidisciplinary Approach
Optimal management requires prompt diagnosis, early referral to an experienced multidisciplinary team, comprising doctors, nurses, therapists, ophthalmology and families working together with school, social and primary healthcare providers.
Management includes screening for complications of disease (especially uveitis), monitoring of the effectiveness and safety of medication, assessing physical growth and pubertal status, as well as evaluation of psychosocial functioning, and optimizing school attendance and family life.
Most patients are managed as outpatients.
Inpatient care is needed for IV steroids as part of induction for disease control, or as a day case for some therapies (joint injections under anaesthetic or using inhaled analgesia) or some biologics.
Many children have treatments given at home (e.g. Methotrexate injections or some biologics) and parents and children themselves can administer medications.
Education and ongoing support from nurses are key to safe home administration. This includes how to manage, store and dispose of needles and syringes.
Patients on immunosuppression can become unwell very quickly and families need to know when to seek health care.
The role of the nurse specialist in the management of rheumatic disease is detailed in pmm for nurses