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“To regain one’s health” – patients’ preferencesof treatment outcomes in early rheumatoid arthritis – a qualitative study
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden & RandD Spenshult, Halmstad, Sweden.
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden & RandD Spenshult, Halmstad, Sweden & Department of Regional Health Research, University of Southern Denmark, Odense, Denmark & Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark.ORCID iD: 0000-0002-8081-579X
Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium & Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven–University of Leuven, Leuven, Belgium.
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2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 648-648Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Rheumatology care strives to identify and meet the needs of the patients, and to understand disease and treatment impact from the patients’ perspective. A better understanding of patients’ expectations from the treatment is needed to enable a patient centered approach in clinical practice and a shared-decision making as recommended in the EULAR treatment recommendations for rheumatoid arthritis (RA). Understanding of patients’ expectations in the early stage of the RA disease may facilitate adherence to treatment, patient independence and prevent unmet needs in the future.

Objectives: To explore patients’ preferred treatment outcomes in early rheumatoid arthritis (eRA).

Methods: A qualitative, explorative study. Individual interviews were conducted with 31 patients with eRA, defined as disease duration of ≤ 1 year and disease-modifying antirheumatic drugs (DMARDs) treatment for 3-6 months 1 . Interviews were analyzed using a constant comparison method according to the Qualitative Analysis Guide of Leuven (QUAGOL) and lasted in a core category and four related concepts.

Results: The patient-preferred treatment outcomes in eRA were described in the core category “to regain one’s health” and the four related concepts: to experience external control of the disease, to experience independence, to regain identity and to experience joy in everyday life. The patients expected to experience external control of the disease by the given treatment to regain one’s health. It was perceived as controlling the symptoms and as absence of disease. Independence was perceived as regaining former activity levels, experiencing autonomy and using active coping strategies. Patients wanted to regain identity through participation, empowerment and their self-image. Joy in everyday life was perceived as vitality and believing in the future.

Conclusion: Patients’ preferred treatment outcomes in eRA were to regain one’s health including both external and internal control. External control as disease control and independence as well as internal control as identity and joy in everyday life. The results from this study can assist healthcare professionals to better understand patients’ preferred treatment outcomes early in the disease process and to tailor the interventions accordingly to improve long term treatment outcome. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019. Vol. 78, no Suppl 2, p. 648-648
Keywords [en]
Rheumatoid arthritis
National Category
Social and Clinical Pharmacy
Identifiers
URN: urn:nbn:se:hh:diva-40917DOI: 10.1136/annrheumdis-2019-eular.1408ISI: 000472207102013OAI: oai:DiVA.org:hh-40917DiVA, id: diva2:1369761
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2020-01-31Bibliographically approved

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Bremander, AnnLarsson, Ingrid

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