RHEUMATOID ARTHRITIS—PLAN TO WIN. Edited by C. Koehn, T. Palmer and J. Esdaile. £19.99. Oxford University Press, Cary, NC, USA, 2002. 284 pages. ISBN 0-951-3056-1

D. Bax, C. Irving

This book has been written by a patient with rheumatoid arthritis, a rheumatologist and a medical writer, all living in Canada. Its subtitle Plan to Win strongly reflects the principal author's personal philosophy on life, undoubtedly influenced by her having been previously a member of the US national volleyball team. This review has been written by a patient with rheumatoid arthritis and a rheumatologist.

The book sets out to be a guide for those with RA and largely achieves this, although throughout there is a tension between the wish to give clear and detailed information and the determinedly up-beat, self-improvement and at times happy-clappy approach.

The sections giving the facts about rheumatoid arthritis, drug and other treatments used are supported by research evidence and are very good. They are clearly presented, non-patronizing and would be read to advantage by all patients with RA and all health professionals caring for them. The parts dealing with the importance of recognizing and treating depression and psychological upset, and the need to realize that one should not feel guilty for having RA nor in failing to rid oneself of it by alternative therapies, are reassuringly sensible and no-nonsense.

The text is at times somewhat dense, detailed and verbose with many lists. The language of the book assumes a fair knowledge of medical terminology, which is a pity since the book is directed towards newly diagnosed patients. There are very few diagrams and those that are included are mostly of poor graphic quality.

There are some fundamental differences between the healthcare systems in Canada and the UK and these are illustrated by comments such as the patient with RA should draw together and lead a team of supportive professionals and that changing your doctor should be regarded as being a similar process to changing your lawyer or accountant.

The approach of encouraging everyone to feel that they are winners in life is a theme that keeps appearing throughout the book, but may not be to everyone's taste or understanding and perhaps reflects the main author's previous exposure to sports psychology. The approach to life expounded in the book has clearly worked for this individual with RA but such a catechism may not suit all. Those parts of the book that enable patients to become better informed and which are based upon evidence are one of the book's strengths.

Other strengths are the comprehensive list of other contacts and other resources, but many of these have a North American or Canadian base. This is an excellent first edition of an important book. In future editions the authors may wish to consider making it more patient-friendly, having a glossary, making the index more comprehensive and incorporating better diagrams.





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