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Palliative care in advanced systemic rheumatic diseases: an integrated approach
  1. Adam Amlani1,
  2. Kirsten Wentlandt2,3 and
  3. Alexandra P Saltman2,4,5
  1. 1University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  2. 2University Health Network, Toronto, Ontario, Canada
  3. 3Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada
  4. 4Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  5. 5Sinai Health System, Toronto, Ontario, Canada
  1. Correspondence to Dr Alexandra P Saltman; alexandra.saltman{at}sinaihealth.ca

Abstract

Despite rapid advances in the field of rheumatology, many patients with rheumatoid arthritis suffer from chronic and debilitating systemic disease, with a high symptom burden and limited life expectancy. In this paper, we demonstrate an approach to managing a patient with rheumatoid arthritis with life-limiting illness for the palliative care physician. In particular, we focus on the systemic nature of rheumatoid arthritis and nuances around medication management towards the end of life. It is our hope that this paper can serve as a guide for the palliative care clinician to decrease end-of-life morbidity from rheumatic disease and rheumatic medications.

  • Palliative Care
  • Rheumatology

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Footnotes

  • X @asaltman

  • Contributors AA and APS were involved in the planning, conception, design, formulation, editing and finalization of the paper. KW was involved in the planning, conception, design, and editing of the paper. APS is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.