Patient experiences with intensive combination-treatment strategies with glucocorticoids for early rheumatoid arthritis

Patient Educ Couns. 2015 Mar;98(3):384-90. doi: 10.1016/j.pec.2014.11.011. Epub 2014 Nov 20.


Objectives: To investigate patients' experiences with intensive combination-treatment strategies with glucocorticoids (ICTS-GCs) in the early phase of early rheumatoid arthritis (ERA) treatment.

Methods: We interviewed 26 participants individually, 4-6 months after initiation of ICTS-GCs (t1). Fourteen participants from the same sample took part in one of three focus groups at least 1 year after treatment initiation (t2). Each interview was audio-recorded, literally transcribed and thematically coded.

Results: The participants described concerns and feelings about ICTS-GCs that changed over time; for example, a fear of side effects diminished when the treatment effects were beneficial or expected side effects did not materialize. Moreover, participants indicated additional information needs at t1 and t2. The most used sources of information were healthcare professionals, relatives, and the Internet. Furthermore, participants reported on their relationship with healthcare professionals and the need for trust and reassurance, especially at t1. Lastly, participants described their personal self-management strategies.

Conclusion: Despite their concerns at treatment initiation, most participants had positive experiences with ICTS-GCs.

Practice implications: Healthcare professionals should be aware that, in the early phase of treatment, they can address patients' concerns, they are the most important information source, they need to create a relationship of trust, and guide patients in self-management strategies.

Keywords: Early rheumatoid arthritis; Intensive combination-treatment strategies; Patient perspective; Qualitative research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Drug Therapy, Combination
  • Early Medical Intervention
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Interviews as Topic
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Netherlands
  • Patient Satisfaction*
  • Practice Patterns, Physicians'
  • Qualitative Research
  • Surveys and Questionnaires
  • Treatment Outcome


  • Antirheumatic Agents
  • Glucocorticoids