Factors influencing the beliefs of patients with rheumatoid arthritis regarding disease-modifying medication

Rheumatology (Oxford). 2004 May;43(5):583-6. doi: 10.1093/rheumatology/keh116. Epub 2004 Feb 17.


Objective: To investigate factors influencing the beliefs of patients with rheumatoid arthritis (RA) regarding disease-modifying medication.

Method: Twenty-nine patients with RA either starting a disease-modifying anti-rheumatic drug (DMARD) for the first time or changing DMARD were recruited. Semi-structured interviews, activity diaries and focus groups were conducted over 9 months. A coding framework was developed and data analysed using the constant comparative method to identify key themes.

Results: DMARDs were perceived as central to the management of RA but strong concerns were expressed about potential long-term effects. Beliefs about DMARDs were informed by material from a wide range of sources. Judgements of efficacy were influenced by symptom relief, occurrence of side-effects and perception of alternative treatment options. Perception, reporting and tolerance of side-effects differed widely between individuals. The emotional impact of starting and being withdrawn from medication appeared stronger in people with more experience of DMARD use.

Conclusions: Patients have complex and evolving belief systems relating to DMARDs. Understanding these systems will facilitate the provision of appropriate information and effective support not only in decision-making about treatment but also in relation to discontinuing treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / psychology
  • Decision Making
  • England
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Treatment Outcome


  • Antirheumatic Agents