“TO REGAIN ONE’S HEALTH” – PATIENTS’ PREFERENCES OF TREATMENT OUTCOMES IN EARLY RHEUMATOID ARTHRITIS – A QUALITATIVE STUDY

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 . 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. REFERENCES: [1] Van der Elst K, Bremander A, De Groef A, Larsson I, Mathijssen E, Vriezekolk J, Westhovens R, van Eijk-Hustings Y. (2019). European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA): rationale, design and methods of a multinational, multicenter, multilingual, longitudinal qualitative study. BMJ Open, accepted 181220 Disclosure of Interests: None declared DOI: 10.1136/annrheumdis-2019-eular.1408Citation: Ann Rheum Dis, volume 78, supplement 2, year 2019, page A648Session: HPR Patients’ perspectives, functioning and health (descriptive: qualitative or quantitative) (Health Professionals in Rheumatology Abstracts)