What is DAS28 Score?
The
DAS28 score stands for Disease Activity Score in 28 joints. It is a quantitative measure used to assess the severity and activity of
rheumatoid arthritis (RA). This score is calculated based on the examination of 28 specific joints, encompassing both swollen and tender joints, in addition to other factors like the patient's global health assessment and
C-reactive protein (CRP) levels or erythrocyte sedimentation rate (ESR).
Monitoring disease progression Evaluating the effectiveness of treatment plans
Guiding adjustments in therapy
Providing a basis for patient education and counseling
Number of swollen joints (out of 28)
Number of tender joints (out of 28)
The patient’s
global health assessment (usually on a scale of 0-100)
Laboratory measure of inflammation, either CRP or ESR
The formula combines these inputs to generate a score typically ranging from 0 to 10, with higher scores indicating more severe disease activity.
Interpreting the DAS28 Score
Understanding how to interpret the DAS28 score is essential for nurses: Remission: DAS28 Low Disease Activity: DAS28 between 2.6 and 3.2
Moderate Disease Activity: DAS28 between 3.2 and 5.1
High Disease Activity: DAS28 > 5.1
Nurses can use these thresholds to evaluate the current status of RA in patients and to make informed decisions regarding their care plans.
Role of Nurses in DAS28 Score Assessment
Nurses are often responsible for the initial assessment and ongoing monitoring of RA patients. Their duties may include: Conducting joint examinations to count swollen and tender joints
Recording and analyzing patient-reported outcomes
Collecting and processing blood samples for CRP or ESR
Communicating findings to the healthcare team
By accurately assessing the DAS28 score, nurses contribute to the optimization of
treatment strategies and overall patient outcomes.
Patient Education and Counseling
Nurses also play a pivotal role in educating patients about their DAS28 scores and what they mean. This includes: Explaining the significance of the score in layman's terms
Discussing how lifestyle changes and medication adherence can impact the score
Providing emotional support and encouragement
Effective patient education can empower patients to take an active role in managing their condition.
Challenges and Considerations
While the DAS28 score is a valuable tool, it is not without limitations. Nurses should be aware of potential challenges such as: Variability in joint assessment accuracy
Patient’s subjective reporting of global health
The need for periodic recalibration and training
By recognizing these challenges, nurses can strive for more accurate and consistent assessments.
