Gabriella Venter1, Joanna Tieu1, Rachel Black2, Susan Lester1, Nieves Leonardo3, Samuel L Whittle1, Elizabeth Hoon4, Claire Barrett5, Debra Rowett6, Rachelle Buchbinder7, Catherine L Hill2. 1. The Queen Elizabeth Hospital, Woodville, South Australia, Australia, and University of Adelaide, Adelaide, South Australia, Australia. 2. The Queen Elizabeth Hospital, Woodville, South Australia, Australia, and University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia. 3. The Queen Elizabeth Hospital, Woodville, South Australia, Australia. 4. University of Adelaide, Adelaide, South Australia, Australia. 5. Redcliffe Hospital, Redcliffe, Queensland, Australia. 6. University of South Australia, Adelaide, South Australia, Australia. 7. Monash University, Melbourne, Victoria, Australia, and Cabrini Institute, Malvern, Victoria, Australia.
Abstract
OBJECTIVE: Prednisolone is an effective oral glucocorticoid for managing symptoms of rheumatoid arthritis (RA) but has predictable and common adverse effects. We explored patient perspectives of prednisolone use in RA. METHODS: Patients with RA registered with the Australian Rheumatology Association Database (ARAD) who had completed an ARAD questionnaire in the preceding 12 months were invited to participate in an online survey. Responses were linked to already collected respondent demographics, medication use, and patient-reported outcome measures. The Beliefs about Medicine Questionnaire (BMQ) measured patient beliefs on medication necessity and concerns. Free-text responses outlining reasons for stopping or declining prednisolone underwent thematic analysis using NVivo 12. RESULTS: The survey response rate was 79.6% (804/1010), including 251 (31.2%) reporting current prednisolone use and 432 (53.7%) reporting previous use. Compared with previous users, current users were older (P = 0.0002) and had worse self-reported pain, disease activity, health-related quality of life, and function (all P < 0.001). Current users had higher BMQ scores for prednisolone-specific necessity (3.6 versus 1.7; P <0.001) and concerns (2.7 versus 2.3; P <0.001). In previous prednisolone users (n = 432), the most frequent themes identified in free-text responses for cessation were adequate disease control (30.3%), adverse effects (25.2%), and predetermined short courses (21.3%). Of respondents citing adverse effects for cessation (n = 131), weight gain (27.5%), osteoporosis (14.7%), and neuropsychiatric issues (13.8%) were most frequent. CONCLUSIONS: In our cohort, patients with RA taking prednisolone believed it was necessary yet remained concerned about its use. Adequate disease control and adverse effects were important considerations for patients using prednisolone.
OBJECTIVE:Prednisolone is an effective oral glucocorticoid for managing symptoms of rheumatoid arthritis (RA) but has predictable and common adverse effects. We explored patient perspectives of prednisolone use in RA. METHODS:Patients with RA registered with the Australian Rheumatology Association Database (ARAD) who had completed an ARAD questionnaire in the preceding 12 months were invited to participate in an online survey. Responses were linked to already collected respondent demographics, medication use, and patient-reported outcome measures. The Beliefs about Medicine Questionnaire (BMQ) measured patient beliefs on medication necessity and concerns. Free-text responses outlining reasons for stopping or declining prednisolone underwent thematic analysis using NVivo 12. RESULTS: The survey response rate was 79.6% (804/1010), including 251 (31.2%) reporting current prednisolone use and 432 (53.7%) reporting previous use. Compared with previous users, current users were older (P = 0.0002) and had worse self-reported pain, disease activity, health-related quality of life, and function (all P < 0.001). Current users had higher BMQ scores for prednisolone-specific necessity (3.6 versus 1.7; P <0.001) and concerns (2.7 versus 2.3; P <0.001). In previous prednisolone users (n = 432), the most frequent themes identified in free-text responses for cessation were adequate disease control (30.3%), adverse effects (25.2%), and predetermined short courses (21.3%). Of respondents citing adverse effects for cessation (n = 131), weight gain (27.5%), osteoporosis (14.7%), and neuropsychiatric issues (13.8%) were most frequent. CONCLUSIONS: In our cohort, patients with RA taking prednisolone believed it was necessary yet remained concerned about its use. Adequate disease control and adverse effects were important considerations for patients using prednisolone.
Authors: Guillermo A Guaracha-Basáñez; Irazú Contreras-Yáñez; Gabriela Hernández-Molina; Viviana A Estrada-González; Lexli D Pacheco-Santiago; Salvador S Valverde-Hernández; José Roberto Galindo-Donaire; Ingris Peláez-Ballestas; Virginia Pascual-Ramos Journal: PLoS One Date: 2022-01-18 Impact factor: 3.240