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THU0757-HPR European qualitative research project on patient-preferred outcomes in early rheumatoid arthritis (EQPERA): rationale, design and methods of an ongoing multi-country, multi-center, multi-language, longitudinal qualitative study
  1. K Van der Elst1,
  2. A Bremander2,
  3. A De Groef1,
  4. I Larsson3,
  5. E Mathijssen4,
  6. J Vriezekolk4,
  7. R Westhovens1,
  8. Y van Eijk-Hustings5
  1. 1Rheumatology, University Hospitals Leuven, Leuven, Belgium
  2. 2Research and Development Center
  3. 3Spenshult Research and Development Center, Spenshult Hospital, Halmstad, Sweden
  4. 4Department of Rheumatology, Sint-Maartenskliniek, Nijmegen
  5. 5Department of Patient & Care/Rheumatology, Maastricht University Medical Center, Maastricht, Netherlands


Background Ample studies exist on outcome assessment from the patient perspective in Rheumatoid Arthritis (RA), but little is known about health and treatment preferences of recently diagnosed patients, and how these evolve over time. A Belgian qualitative study has set the scene (1), but knowledge on cross-cultural nuances in patient-preferred outcomes is lacking. To this end, EQPERA – European Qualitative research collaboration on Patient-preferred outcomes in Early Rheumatoid Arthritis– was founded.

Objectives EQPERA aims to unravel longitudinally preferences for treatment and health outcomes among patients with early RA across Belgium, the Netherlands and Sweden. To yield sound results, specific preparations for this cross-country qualitative study are reported here.

Methods Several steps have been undertaken to ensure trustworthiness of findings and consistency across countries in sampling, interviewing, analysis and project management: a detailed research protocol has been written; the interview guides have been translated following a structured forward-backward linguistic validation process; templates for data collection and a quality assurance reporting tool have been developed; and local staff has been trained and supervised by the project leader in implementing the study protocol. Each country will document changes with sufficient detail in their research logbook.

Results EQPERA will be a qualitative, explorative, longitudinal study with active involvement of patient researchers. In each country, a purposive sample of patients with early RA will be individually interviewed 3–6 months after start of the initial RA treatment and subsequently, the same participants will be invited back to take part in a focus group 12–18 months after RA treatment initiation. Data collection and analysis will be independently conducted by the local research teams in their native language. The local teams will analyze their interview data using the constant comparison method as detailed in Qualitative analysis guide of Leuven, after which Saldana's guiding questions will be adopted for analyzing change over time. Afterwards, a meta-synthesis of all locally gathered and interpreted data will be conducted to explore and describe patterns, similarities and differences across countries.

Conclusions This European project is a first step in gathering contextual findings on patient-preferred outcomes in early RA. Such knowledge is of crucial importance for tailoring therapeutic approaches in a timely and meaningful way. Our innovative, qualitative, longitudinal research design goes beyond the abilities of the frequently used cross-sectional designs in qualitative research. Large, multi-national qualitative projects are scarce in rheumatology research, thus applied data management and quality assurance strategies could be of interest to other researchers.


  1. Van der Elst K, et al. Unraveling Patient-Preferred Health and Treatment Outcomes in Early Rheumatoid Arthritis: A Longitudinal Qualitative Study. Arthritis Care Res (Hoboken). Arthritis Care Res (Hoboken). 2016;68(9):1278–87.


Disclosure of Interest None declared

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