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Extended report
Patient preferences for psychological support in inflammatory arthritis: a multicentre survey
  1. Emma Dures1,
  2. Celia Almeida1,
  3. Judy Caesley2,
  4. Alice Peterson2,
  5. Nicholas Ambler3,
  6. Marianne Morris1,
  7. Jon Pollock1,
  8. Sarah Hewlett1
  1. 1Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
  2. 2Academic Rheumatology, University Hospitals Bristol, Bristol, UK
  3. 3Pain Management Centre, North Bristol NHS Trust, Bristol, UK
  1. Correspondence to Dr Emma Dures, Academic Rheumatology, Bristol Royal Infirmary, Bristol BS2 8HW, UK; emma2.dures{at}


Objectives Inflammatory arthritis (IA) can lead to anxiety, depression, pain and fatigue. Psychological support can improve quality of life and self-management; and European and American guidelines recommend support be offered. This study examined patient views on psychological support for their IA.

Methods A questionnaire designed by researchers, patient partners and clinicians was administered to 2280 patients with IA.

Results 1210 patients responded (53%): 74% women; mean age 59 years (SD 12.7); patient global 5 (2.3); disease duration <5 years (41%), 5–10 (20%), >10 (39%). Only 23% reported routinely being asked about social and emotional issues by a rheumatology professional, but 46% would like the opportunity to discuss psychological impact. If offered, 66% of patients reported they would use a self-management/coping clinic (63% pain management, 60% occupational therapy, 48% peer support groups, 46% patient education, 46% psychology/counselling). Patients want support with managing the impact of pain and fatigue (82%), managing emotions (57%), work and leisure (52%), relationships (37%) and depression (34%). Preferences are for support to be delivered by the rheumatology team (nurse 74%, doctor 55%) and general practitioners (GPs) (51%). Only 6% of patients stated that social and emotional issues were not relevant.

Conclusions Demand for psychological support is high; however, less than a quarter of patients reported being asked about social and emotional issues, suggesting a gap between needs and provision. The preference is for delivery from rheumatology clinicians and GPs, and research should establish whether they have the skills and resources to meet patients’ needs.

  • Health services research
  • Patient perspective
  • Psychology

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