Ask the Pharmacist: Managing the aches and pains of arthritis

(BPT) – Arthritis can strike at any age. In fact, of the 50 million Americans suffering from arthritis, two-thirds are under the age of 65. Each year, arthritis accounts for 44 million outpatient visits, over 900,000 hospitalizations and has quickly become the leading cause of disability in the United States, outnumbering activity limitations caused by heart disease, cancer or diabetes. Making the right lifestyle and medication decisions can be the difference between living a healthy, full life and living with a serious disability.

The specially trained pharmacists in the Express Scripts Rheumatoid Arthritis and Inflammatory Disease Therapeutic Resource Center, offered through Accredo, have disease-specific expertise and spend the majority of their time counseling patients with these conditions.

“It’s important to know that arthritis is not one condition, but a complex family of musculoskeletal disorders consisting of more than 100 different diseases,” says Phyllis Crockett, specialist pharmacist at Express Scripts. “Of the arthritis population, 60 percent are women and several types of arthritis are more prevalent in women.”

The most common forms of arthritis are osteoarthritis (OA), rheumatoid arthritis (RA) and juvenile arthritis (JA), which account for about 58 percent of all patients. OA is characterized by a breakdown of joint cartilage and primarily affects elderly patients. RA is characterized by inflammation of the membranes lining the joint. Lastly, JA describes many autoimmune and inflammatory conditions that can affect children ages 16 and younger.

“Managing the disease so that patients can continue to live normal lives is important,” Crockett says. “Each patient is different and so are their treatment plans, but there are a few things everyone can do that can help manage symptoms.”

Crockett offers the following suggestions to help the arthritis population.

* Do not self-medicate: Combining over-the-counter medications with prescription medications can be risky and can cause side effects such as an increase in gastrointestinal irritation or a gastrointestinal bleed. Check with a doctor or specialist pharmacist before adjusting doses or making changes to the medication regimen.

* Take as directed: For patients who already are on medication to treat the condition, adherence is critical. If patients do not take their medication as prescribed they may be faced with disability or rapid progression of the disease.

* Watch for drug interactions: Some common medications such as acetaminophen can have a drug-drug interaction with arthritis medications. Limit intake and remember that acetaminophen is often a component in common sinus, cough/cold and pain medications. Some foods and beverages can also block the effects of arthritis medications. These include grapefruit, apple and orange juice as well as milk and yogurt. Wait at least four hours after taking medications before ingesting these products. Exact times can vary depending on the disease and the treatment. Check with your healthcare professional if you have any questions.

*Stay active: OA and RA patients particularly can benefit from both endurance and resistance training. Additionally, every pound of weight lost reduces the pressure on each knee by 4 pounds. Maintaining a healthy weight and protecting against joint injury can help prevent OA.

For more information and additional ways to become a more engaged and empowered patient, visit the Express Scripts Healthcare Insights blog at

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