Background In recent years, there has been a focus on treat-to-target strategies in newly/recently diagnosed RA patients, particularly since launch of NICE RA Guideline in 20091, using DAS28 to determine a jointly agreed goal for reduction in disease activity. From a clinical perspective, DAS of < 2.6 represents ‘remission’2, however this is a health professional perspective and does not necessarily reflect what patients feel about their disease and its impact on their lives. NRAS is working to gain a better insight into the views and experiences of people living with RA and their perceptions of the reality of achieving remission and their personal view of what remission means. This work is supported by Roche/Chugai and their PR agency Reynolds-MacKenzie (R-M)
Methods NRAS recruited a group of 15 individuals ranging from relatively recently diagnosed to those with longer standing disease to attend a focus group in London. A framework of questions to guide the focus group discussion was developed and the group was jointly facilitated by NRAS and R-M. The purpose of the focus group was to guide the development of a survey to be sent out to NRAS members and non-members via NRAS social media sites. Objectives of the session were: to gain an understanding of people’s interpretation of remission including; how realistic they felt the goal of remission was; what remission in RA looks like; the social and personal impact of achieving or not achieving remission; the barriers to achieving remission and whether DAS remission was meaningful. The discussions were subsequently written up and used to guide the development of the survey
Results A 34 question survey was developed in Survey Monkey and sent to NRAS members with email addresses. It was also posted on the NRAS social media sites and on the main website, so that people with RA who are not members could also take part. 1,100 surveys have been returned and are being analysed during first quarter 2013. The results will be used to raise awareness amongst rheumatology healthcare professionals (HCPs) of the views of people with RA around remission which we hope will lead to a better understanding by HCPs about what is important to patients when discussing potential treatment outcomes, including DAS outcomes. It is also intended to use the survey results to raise awareness through media outreach of RA generally, and what is important to people with RA when considering treatment goals
Conclusions We cannot draw conclusions until we have analysed the results of the survey (which we would like to be able to present at EULAR), but output from the focus group would indicate that DAS28 is not considered overly useful as a number is seen as less helpful than knowing how patients feel and understanding their own personal goals, and RA specialists do not seem to be proactive in driving patients towards remission
1 & 2 Rheumatoid arthritis: the management of rheumatoid arthritis in adults. Clinical guidelines, CG79 - Issued: February 2009.
Acknowledgements This work is being supported by Roche/Chugai resource, though NRAS has received no educational grant
Disclosure of Interest None Declared