Rheumatology Department

• General rheumatology clinics
• Procedure clinic 
• Early arthritis clinic 
• Ankylosing spondylitis clinic 
• Musculoskeletal physiotherapy clinics
• Inpatient consult service 
• Active involvement in research and education 
• Close links with physiotherapy and occupational therapy services 
• Rheumatology advanced nurse practitioner clinics, including a comprehensive DMARD Clinic for new patients commencing an oral DMARD agent and for patients requiring further support and monitoring 
• Virtual biologics clinic for stable patients on biologic therapies 
• Reproductive health clinic to educate, support and monitor patients from the pre-conception phase to the early post partum period
• Rheumatology Clinical Nurse Specialist Service for screening, educating and supporting patients commencing or switching DMARD/biologic treatments
• Clinical Nurse Specialist telephone advice line
• Rheumatology Infusion Service

Access to this service is via GP/ Physician referral. On all referrals, please state the reason for referral and give results of relevant laboratory/ radiology investigations.

Referrals to the Rheumatology Department can be made via Healthlink or by writing to:

Rheumatology Department
St James’s Hospital
James Street
Dublin 8

For patients with suspected new onset inflammatory arthritis please use the national Early Arthritis Referral Form www.isr.ie

The Rheumatology Nurse Advice Line (NAL) is available only to current patients of the rheumatology service. The helpline is intended to assist with the following items:

1. Advice regarding your arthritis and flare management

2. Advice regarding your medications, side effects, or other related concerns

3. Nursing (only) appointments queries

The helpline cannot facilitate the following:

1. Test results - we are unable to give results over the phone. Tests ordered by the rheumatology team will be followed up by the doctors.
2. Doctor appointment or waiting list queries - please contact your consultant’s secretary.
3. Methotrexate prescriptions

The helpline is available to receive messages Monday to Friday, 9am to 2pm.

Please do not leave a message outside these times as the helpline will not be attended to.

If you require urgent attention, please contact your GP or Out of Hours service.

Getting started on your medication

Your doctor may decide to start you on a medication to treat your rheumatological condition. A referral is sent to specialist nurses who will go through the process with you. They will discuss this medication with you, organise any further tests that may be required and review your progress in specialist clinics.

Many of these medications are covered by the Drugs Payment Scheme. For more information visit Drugs Payment Scheme to see if you are eligible for the scheme.

HighTech prescriptions

HighTech Prescriptions are valid for 6 months. If you are on a HighTech medication and require a repeat prescription from the Rheumatology team please see below:

1. You must attend regularly for blood tests.
2. You must attend all clinic appointments to review your progress on these medications.
3. Prescriptions will be sent via E-script to your pharmacy via the HighTech Hub. You will not receive a copy in the post.

Methotrexate

Methotrexate is a disease-modifying anti-rheumatic drug (DMARD). DMARDs are used to treat inflammatory arthritis such as rheumatoid arthritis, psoriatic arthritis, juvenile arthritis and ankylosing spondylitis. Most DMARDs act by regulating the immune system. They are not specific painkillers, but they lessen the activity of arthritis by reducing swelling and stiffness - thereby reducing the pain.

There are other DMARDs that may be prescribed for you. Your rheumatology nurse will go through your medication with you in more detail.

Methotrexate comes in tablet and injection form. Please visit the links below to help you understand how to use your methotrexate injection pen.

Nordimet Pen – How to use 

Metoject Pre-Filled Pen – How to use 

Methofill Methotrexate SELF INJECT – How to use

Infusions

Biologic therapies can be given as an infusion. Infusion therapy provides patients with medication administered intravenously. Your rheumatology infusion will be given in MACS . The day and time of your appointment will depend upon the kind of infusion you are going to have. Your rheumatology nurse will discuss this with you in more detail.

 

 

You will need your bloods monitored regularly and your rheumatology doctor or nurse will inform you of how often these tests are required.

Patients are responsible for booking their own blood tests.

The Out Patient Phlebotomy Department is located in the main Outpatient Department (OPD), Route 1. The Out Patient Phlebotomy Department opening hours are:

Monday – Friday (excluding holidays), 7.30am – 16.30pm.

 

Use the following options to book an appointment on Swiftqueue for an Out Patient Phlebotomy Department appointment:

• https://www.stjames.ie/patients/bloodtesting/outpatientbloodtesting/
• QR code

 

• Alternatively you can ‘walk in’ and wait for the next available

Are you having issues logging in/booking a blood test on Swiftqueue? Please contact the Swiftqueue Help Centre on the link below:

https://swiftqueue-ie.zendesk.com/hc/en-gb

If you attend your GP for blood tests please post, fax or email results to your consultant’s secretary.

Fax number 01 428 4170

Please contact the following services to organise sharps bin collection:

Hibernian

Call 01 460 4820

Call 01 460 4792

Amgevita (Adalimumab)	Methofill - Methotrexate
Benepali (Etanercept)	Nordimet - Methotrexate
Enbrel (Etanercept)
Hulio (Adalimumab)
Idacio (Adalimumab)
Imraldi (Adalimumab)
Orencia (Abatacept)
Remsima (Infliximab)
Tyenne (Tocilizumab)
Yuflyma (Adalimumab)

TCP

Call 1800 936 807

Email waste-management@tcp.ie

Cimzia (Certolizumab Pegol)

Simponi (Golimumab)

Stelara (Ustekinumab)

Tremfya (Guselkumab)

Taltz (Ixekizumab)

Novartis

Call 1800 303 510

Email cosentyx.medireland@novartis.com

Cosentyx ( Secukinumab)

Stericycle

Call 1800 937 628

RoActemra (Tocilizumab)

Metoject - Methotrexate

AbbVie Care

Call 1800 200 573

Visit www.abbviecare.ie

Humira (Adalimumab)

Skyrizi (Risankizumab)

Many people with a Rheumatological condition will experience flare ups. It is common for pain to flare-up even though you have been pacing, building up your activities and exercises gradually and practicing relaxation. This can be very frustrating, and make you feel like you have little control over your pain.

If flaring, please follow some of the advice suggested in the links below. If after following some of this basic advice and your symptoms do not improve then contact our Nurse helpline.

Managing flares in rheumatoid arthritis

Managing your pain

Treatment for arthritis goes beyond medication and the ability to self-manage your condition an essential part of your care.

Self-management is what a person does every day to manage their long-term health condition and involves managing the practical, physical and psychological impacts of disease.

https://www.hse.ie/eng/health/hl/selfmanagement/living-well-programme/ 

Don’t forget to Mind Your Bones. Osteoporosis is a worldwide health issue and the most common skeletal disorder today, with an estimated 300,000 people in Ireland currently living with the condition. Many of the recommendations for inflammatory arthritis patients about protecting their bones and preventing osteoporosis are the same as the advice given to the general population.

• Diet

A balanced diet forms the foundations of healthy eating and is for musculoskeletal health. Calcium and Vitamin D need to be taken in the right amounts throughout life, to help keep your bones healthy. Supplements can help ensure that you get adequate amounts of calcium each day.

• Exercise

The National Guidelines on Physical Activity recommend that adults take part in at least 30 minutes of moderate intensity activity on five days a week (or 150 minutes a week). Weight-bearing, resistance-style exercises are particularly important for bone and muscle health.

Regular exercise is proven to be one of the most effective treatments for arthritis. It can make a big difference to your bones and how you live with arthritis. Visit Arthritis Ireland to find out how exercise can help you improve your health and fitness without hurting your joints.

• Healthy Lifestyle

Smoking is bad for bones as well as the heart and lungs. Women who smoke tend to go through menopause earlier, resulting in earlier reduction in levels of the bone-preserving hormone estrogen and triggering earlier bone loss. In addition, people who smoke may absorb less calcium from their diets. If you want to quit we can offer support by referring you to Smoking Cessation

Alcohol also can have a negative effect on bone health. Those who drink heavily are more prone to bone loss and fracture, because of both poor nutrition and increased risk of falling. Always seek advice before drinking if you have a medical condition that may be worsened by alcohol or if you are on certain medication.

 

What can I do to protect myself?

One of the most important things you can do is to listen to advice from a credible source. For the most up to date information on the Coronavirus and the national roll-out of COVID 19 vaccines please visit www2.hse.ie/coronavirus and https://www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/ .

Are you working from home?

Moving regularly and continuing to be physically active is key to working well at home.

Are you recovering from COVID?

This booklet is designed to give you simple advice to help you recover after your COVID-19 infection.

https://askthephysio.ie/wp-content/uploads/2021/09/ISCP-9-6-21.pdf

Arthritis Ireland

Versus Arthritis

National Rheumatoid Arthritis Society

National Axial Spondyloarthritis Society

Fibro Ireland

Lupus Group Ireland

Scleroderma and Raynauds UK

Irish Osteoporosis Society

HSE Quit Smoking

St. James’s Hospital is a participating site in the Ankylosing Spondylitis Registry Ireland (ASRI). More information can be found in our ASRI Privacy Notice below.

ASRI Privacy Notice December 2023