Immunosuppression medications can cause patient fear especially given the side effect profile. These medications are prescribed when benefits >>> risks. Patients who are at high risk of certain complications are not prescribed the medication.
What can you do?
- Regarding infection, educate patients that these medications can be held during infection
- Regarding renal, hepatic, and cytopenia side effects close monitoring is done (initially monthly, then every 3 months for most medications)
- Some patients are fearful of injection – nurse teaching can be very valuable.
Monitoring
Most of these medications require close blood monitoring, and contraindications are reviewed before starting
Cost
- Cost can be prohibitive.
- cDMARDs are cheaper.
- For more expensive medications, there may be patient assistance programs.