L J Goodacre1, J A Goodacre. 1. Lancashire School of Health and Postgraduate Medicine, University of Central Lancashire, Preston, UK. lgoodacre@uclan.ac.uk
Abstract
OBJECTIVE: To investigate factors influencing the beliefs of patients with rheumatoid arthritis (RA) regarding disease-modifying medication. METHOD: Twenty-nine patients with RA either starting a disease-modifying anti-rheumatic drug (DMARD) for the first time or changing DMARD were recruited. Semi-structured interviews, activity diaries and focus groups were conducted over 9 months. A coding framework was developed and data analysed using the constant comparative method to identify key themes. RESULTS: DMARDs were perceived as central to the management of RA but strong concerns were expressed about potential long-term effects. Beliefs about DMARDs were informed by material from a wide range of sources. Judgements of efficacy were influenced by symptom relief, occurrence of side-effects and perception of alternative treatment options. Perception, reporting and tolerance of side-effects differed widely between individuals. The emotional impact of starting and being withdrawn from medication appeared stronger in people with more experience of DMARD use. CONCLUSIONS: Patients have complex and evolving belief systems relating to DMARDs. Understanding these systems will facilitate the provision of appropriate information and effective support not only in decision-making about treatment but also in relation to discontinuing treatment.
OBJECTIVE: To investigate factors influencing the beliefs of patients with rheumatoid arthritis (RA) regarding disease-modifying medication. METHOD: Twenty-nine patients with RA either starting a disease-modifying anti-rheumatic drug (DMARD) for the first time or changing DMARD were recruited. Semi-structured interviews, activity diaries and focus groups were conducted over 9 months. A coding framework was developed and data analysed using the constant comparative method to identify key themes. RESULTS: DMARDs were perceived as central to the management of RA but strong concerns were expressed about potential long-term effects. Beliefs about DMARDs were informed by material from a wide range of sources. Judgements of efficacy were influenced by symptom relief, occurrence of side-effects and perception of alternative treatment options. Perception, reporting and tolerance of side-effects differed widely between individuals. The emotional impact of starting and being withdrawn from medication appeared stronger in people with more experience of DMARD use. CONCLUSIONS:Patients have complex and evolving belief systems relating to DMARDs. Understanding these systems will facilitate the provision of appropriate information and effective support not only in decision-making about treatment but also in relation to discontinuing treatment.
Authors: Kathleen M Andersen; Ayano Kelly; Anne Lyddiatt; Clifton O Bingham; Vivian P Bykerk; Adena Batterman; Joan Westreich; Michelle K Jones; Marita Cross; Peter M Brooks; Lyn March; Beverley Shea; Peter Tugwell; Lee S Simon; Robin Christensen; Susan J Bartlett Journal: J Rheumatol Date: 2019-02-15 Impact factor: 4.666
Authors: Yvonne Nestoriuc; E John Orav; Matthew H Liang; Robert Horne; Arthur J Barsky Journal: Arthritis Care Res (Hoboken) Date: 2010-06 Impact factor: 4.794