Fear and uncertainty. These are two of the predominant emotions that follow a diagnosis of any one of over a hundred forms of arthritis. Beyond the questions about the causes of the disease, which are largely unanswered, virtually every patient’s focus shifts to the same question: So, what next? Once the physician has established a diagnosis, the next step is to refer to clinical practice guidelines for suggestions about how to treat it.

Clinical practice guidelines are sets of statements that establish possible patterns of treatment and help provide the context within which treatment options are examined and tested. Guidelines are intended to guide rather than prescribe, since the physician’s judgment and experience, along with specific characteristics unique to each patient, form the foundation of any treatment plan. Clinical practice guidelines provide a reference point from which such a treatment plan is formulated.

Guidelines are formulated by expert panels and are subjected to rigorous external review by physicians, clinicians and patient advisory groups. The criteria that reviewers use ensure that new guidelines, or the modification of an existing guideline, result from sound methodology and are based on evidence. Acceptable guidelines define practice that meets the needs of most patients most of the time.

The use of guidelines is not limited to treatment options. Since they define treatment options, and because such options require an understanding of the nature and severity of the disease, guidelines are also useful in informing diagnosis. As such, guidelines form a critically important tool in the detection and management of arthritis.

Guidelines are not meant to be eternal. As new research becomes available, and as new pharmaceuticals are developed, tested and marketed, the continuous process of analysis takes place across a broad spectrum of clinicians and practitioners. Guidelines should then be thought of as organic documents that grow and adapt with changing knowledge.

For now, at least, arthritis is a life sentence, but not all is darkness and despair. We might still feel mildly uncertain, but knowing that our physicians are following clinical practice guidelines, we can live without fear.

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Footnote:

Patients may wish to learn more the about the latest arthritis guidelines as part of becoming an active and genuine partner with their health care professionals.

• The Osteoarthritis Guidelines are explained by Dr. Jolanda Cibere in a plain language, patient friendly video presentation.
• American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee.
• Canadian Rheumatoid Arthritis Guidelines
• The National Guideline Clearinghouse, a US based organization, has published a variety of guidelines.