Background: Since there are few studies done on RA, this study will complement the previous studies already done on the pharmacological management of RA which will be critical for further implementation of policies in the Ministry of Health for the management of RA in Kenya.
Objectives: 1. To determine the prevalence of Rheumatoid Arthritis in the elderly population of above 60 years at Kenyatta National Hospital for the past 5 years. 2. To evaluate the pharmacological management of Rheumatoid Arthritis among geriatrics at KNH. 3. To analyze the adverse effects of anti-rheumatic medication among the geriatrics with comorbidities at KNH for the past 5 years.
Methods: The study is a descriptive cross-sectional study. One hundred and eighty four (184) files of patients admitted between 2018 and 2022 are used in the study. The data includes the elderly patients of over 60 years diagnosed with RA at the KNH medication database. The treatment sheet for each patient is used to obtain the different drugs used in the patient pharmacological management. Patient demographic and clinical data characteristics is included in the data collection abstraction form. The raw data collected is cleaned and coded for analysis using XLSTAT statistical software in Excel Sheet and data representation will be done in form of pie charts, bar graphs and tables.
Results: A total of ninety-four (94) patient files at Kenyatta National Hospital (KNH) of the years 2018- 2022 were reviewed and data was extracted for the patients’ gender, age, weight, height, marital status, county of residence and occupation. Medical records for 90 deceased patients could not be traced by the hospital staff for the study period. Female patients had the highest percentage of Rheumatoid arthritic cases of 75.53% while the males had a percentage of 24.47%. Nairobi county had the highest prevalence of the ailment with a percentae of 24.43% as compared to Nakuru wherein it was 1.06% of patient with the ailment. Hydroxychloroquine (14.49%) was the most used medication for treatment, then Methotrexate (12.78%) and folic acid (11.08%) then prednisolone (12.50%).
Conclusions: In conclusion, the study showed that there was a higher prevalence of RA in females than in males. There were more non-smokers and non-drinkers who had RA though smoking and drinking are significant risk factors in RA. Hypertension, diabetes mellitus, osteoarthritis and CKI were the most prevalent comorbidities. Gastrointestinal ulceration, gastrointestinal disturbances such as nausea, vomiting and abdominal pain, immunosuppression were the most highlighted adverse drug events. Overally, there was a positive therapeutic outcome from RA pharmacological management which was also in line with the treatment guidelines for RA.
