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Clinical Conference Granisetron (Kytril) suppresses methotrexate-induced nausea and vomiting among patients with inflammatory arthritis and is superior to prochlorperazine (Stemetil). free! 1999
Devlin J, Wagstaff K, Arthur V, Emery P. · Rheumatism and Rehabilitation Research Unit, University of Leeds, UK. · Rheumatology (Oxford). · Pubmed #10325668 links to free full text
Abstract: OBJECTIVE: Methotrexate (MTX) is an increasingly popular anti-rheumatic drug with its usefulness limited by toxicity, most commonly gastrointestinal (GI). The aim of the study was to study the effectiveness of the 5-HT3 receptor antagonist granisetron (GR) in the therapy of MTX-induced nausea. METHODS: A single-blind 8 week pilot study with random allocation to either GR 1 mg or prochlorperazine (Stemetil; PCh) 10 mg was undertaken in 13 patients who were taking or had taken MTX for either rheumatoid arthritis (10) or psoriatic arthritis (3). RESULTS: One in six patients treated with PCh completed the 8 week study compared to 7/7 treated with GR. After switching of symptomatic patients, 11 completed the study on GR and median improvement was by two grades (P < 0.001) with a significantly better visual analogue scale score for patient satisfaction compared to PCh. CONCLUSION: Treatment with GR may be useful in establishing and maintaining some patients on MTX where GI toxicity would have precluded such therapy.
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Article Rheumatology: a study of patient satisfaction with follow-up monitoring care. 2004
Arthur V, Clifford C. · Rheumatology Department, Selly Oak Hospital, University Hospital Birmingham NHS Trust, Birmingham, UK. · J Clin Nurs. · Pubmed #15009335 No free full text.
Abstract: BACKGROUND: This paper reports the findings of a quantitative study to determine the satisfaction of rheumatology patients receiving follow-up monitoring care within primary and secondary locations. AIMS AND OBJECTIVES: The aim of the study was to compare and contrast the satisfaction of patients with rheumatoid arthritis following two different routes of care. The objective was to explore the dimensions of care identified in an earlier qualitative study. DESIGN: A convenience sample of 80 participants was used; 40 from each care location. METHODS: Data were collected using the Leeds Satisfaction Questionnaire, which explores the dimensions of satisfaction previously identified as being important to this group of patients. RESULTS: The secondary care group showed significantly higher levels of satisfaction in respect of general satisfaction, provision of information and continuity of care and a significant difference in relation to empathy, technical ability and attitude to the patient. CONCLUSIONS: While patients from both locations were satisfied with the care they received, those receiving specialist nursing care in the secondary location were more satisfied. RELEVANCE TO CLINICAL PRACTICE: Increased emphasis on care in the community and the evolution of nurse specialist roles indicate the need for further qualitative work to inform the future planning of care provision for rheumatology patients in this area.
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