PALLIATIVE CARE IN SPONDYLOARTHRITIS: IS THERE A NEED FOR THIS?

Objective: to estimate the rehabilitation  or palliative care needs of patients with spondyloarthritis  (SpA) and to determine the specific features of palliative care in them.

Subjects and methods. The literature on the investigated problem was analyzed using the electronic resources of Pubmed,  Medline,  and E-library. The authors obtained data based on the prospective follow-up of 182 patients with SpA in January 2010 to March 2014 (PROGRESS study). The degree of axial skeletal immobility (Bath Ankylosing Spondylitis Metrology Index (BASMI)) was estimated; the presence of irreversible organ changes (uveitis-induced visual loss, chronic renal failure due to amyloidosis, etc.), and X-ray changes of the joints and spine were specified. The number of people with varying degrees of disability and that of those needing surgery were taken into account.

Results. The investigation showed that mobility changes and disability might progress rapidly in patients with SpA: in 2010 to 2014, the number of disable patients with SpA increased from 20.5 to 48.9%. In 2014, more than one third (37.8%) of the patients needed rehabilitation  and orthopedic  correction; 5 (2.74%) patients had IV functional class and required nursing and palliative care.

Conclusion. SpA is a chronic disease that can lead to a rapid functional impairment. Chronic  pain, loss of mobility, vision deterioration, amyloidosis, and other causes show the need for palliative care in some patients with SpA. Special tools for evaluating the health status of patients with SpA should be elaborated to determine whether the patient needs rehabilitation  and palliative care.

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