Background Despite the growing interest of rheumatologists into the patients' perspective in the last decade (1) and the wide use of patient-reported outcomes in the assessment of Rheumatoid Arthritis (RA) (2,3) and Spondyloarthritis (SpA) (4), the main fears and beliefs of these group of patients and their consequences on treatment outcomes are unclear.
Objectives To assess the main fears and beliefs of people with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) from different continents and their effect on treatment outcomes;
Methods A systematic literature review was conducted in Pubmed/Medline. All original articles published up to December 2014, reporting fears and/or beliefs of adult patients with RA, AS or PsA were analyzed. Fears and beliefs were collected by two independent researchers and grouped in categories.
Results Of the 293 publications identified, 70 were analyzed, corresponding to 19,161 RA, 1,693 AS/Spondyloarthritis and 202 PsA patients. No article reported fears and/or beliefs of people living in Latin America, Africa or Oceania. Fears were reported in 19 articles of which 9 (47.4%) reported fears related to pharmacological therapy. Beliefs were reported in 59 articles: beliefs about the rheumatic disorder were found to affect the impact of disease (in N=24 articles, 40.7% of articles assessing beliefs), beliefs about therapy were sometimes linked to adherence (N=11, 18.6%) and beliefs about cause of disease influenced coping strategies and adherence (N=5, 8.5%). Beliefs mediated the emotional impact of disease in RA (N=9, 15.2%) and influenced functioning in AS and RA (N=4, 6.8%).
Conclusions Patients' beliefs are linked to impact of disease and non-adherence in RA, AS and PsA. Further research is needed on fears of PsA and AS patients and on fears/ beliefs of patients living outside Europe and North America.
Enhanced Patient Involvement and the Need to Revise the Core Set - Report from the Psoriatic Arthritis Working Group at OMERACT 2014. Tillett W, Eder L, Goel N, De Wit M, Gladman DD, FitzGerald O et al. J Rheumatol. 2015; 42(11): 2198–203.
Patient-reported outcomes as end points in clinical trials in rheumatoid arthritis. Gossec L, Dougados M, Dixon W. RMD Open. 2015; 2:1(1).
Reporting of patient-reported outcomes in recent trials of rheumatoid arthritis:a systematic literature review. Kalyoncu U, Dougados M, Daurès JP, Gossec L. Ann Rheum Dis.2009;68 (2): 183–90.
Clinical outcomes in psoriatic arthritis: A systematic literature review. Palominos PE, Gaujaux-Viala C, Fautrel B, Dougados M, Gossec L. Arthritis Care Res (Hoboken). 2012; 64(3): 397–406.
Disclosure of Interest None declared