Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study

BMJ Open. 2018 Dec 14;8(12):e024367. doi: 10.1136/bmjopen-2018-024367.


Objectives: The aims were to identify patients with rheumatoid arthritis (RA) who had stopped drinking alcohol and compare them with patients drinking alcohol, and to explore reasons for stopping drinking alcohol.

Design: A sequential explanatory mixed methods design was used.

Setting: Six rheumatology clinics in Southern Sweden Better Anti-Rheumatic FarmacOTherapy cohort.

Participants: A total of 1509 patients completed the questions about alcohol and were included in the study. 86 of these had stopped drinking alcohol and 72 responded to the open question and their answers were analysed with qualitative content analysis.

Outcome measures: The quantitative data were from a cross-sectional survey assessing disease severity, physical function (Health Assessment Questionnaire, HAQ) and health-related quality of life (EuroQol five dimensions, EQ5D), pain, fatigue, patient global assessment (PatGA) and lifestyle factors, for example, alcohol. The questions assessing alcohol included an open question 'Why have you stopped drinking alcohol?'

Results: The patients who stopped drinking alcohol were older (median (min-max) 69 (36-90) vs 66 (23-95), p=0.011), had worse HAQ (1.00 (0-2.75) vs 0.50 (0-3.00), p<0.001), worse EQ5D (0.69 (-0.02-1.00) vs 0.76 (-0.58-1.00), p<0.001) worse PatGA (5 (0-10) vs 3 (0-10), p<0.001), more pain (5 (0-10) vs 3 (0-10), p<0.001) and more fatigue (6 (0-10) vs 4 (0-10), p<0.001 compared with patients drinking alcohol. The qualitative content analysis revealed five categories describing reasons for patients with RA to stop drinking alcohol: illness and treatment; health and well-being; work and family; faith and belief; and dependences and abuse.

Conclusions: The patients who had stopped drinking had worse physical functioning and higher levels in pain-related variables. Most stopped drinking due to their illness or a desire to improve health.

Keywords: qualitative research; rheumatology.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged, 80 and over
  • Alcohol Abstinence / psychology*
  • Alcohol Drinking / psychology
  • Alcoholism / psychology
  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / psychology*
  • Cross-Sectional Studies
  • Family
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / etiology
  • Quality of Life
  • Religion
  • Sweden
  • Work
  • Young Adult