Evidence map›Paper›PMID 28732151›Full record

SynthesisArthritis care & research2018

Patients' Attitudes and Experiences of Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis and Spondyloarthritis: A Qualitative Synthesis.

Ayano Kelly, Kathleen Tymms, David J Tunnicliffe, Daniel Sumpton, Chandima Perera, Kieran Fallon, Jonathan C Craig, Walter Abhayaratna, Allison Tong

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Arthritis care & research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed
5.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 66 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Ayano KellyCanberra Rheumatology and Australian National University, Canberra, Canberra Hospital, Woden, Australian Capital Territory, and The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Kathleen TymmsCanberra Rheumatology and Australian National University, Canberra, and Canberra Hospital, Woden, Australian Capital Territory, Australia.
David J TunnicliffeThe Children's Hospital at Westmead, Westmead, and Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Daniel SumptonThe Children's Hospital at Westmead, Westmead, and Liverpool Hospital and Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
Chandima PereraCanberra Hospital, Woden, Australian Capital Territory, Australia.
Kieran FallonCanberra Hospital, Woden, and Australian National University, Canberra, Australian Capital Territory, Australia.
Jonathan C CraigThe Children's Hospital at Westmead, Westmead, and Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Walter AbhayaratnaCanberra Hospital, Woden, and Australian National University, Canberra, Australian Capital Territory, Australia.
Allison TongThe Children's Hospital at Westmead, Westmead, and Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Canberra Hospital · AUAustralian National University · AUChildren's Hospital at Westmead · AUUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNonadherence to disease-modifying antirheumatic drugs (DMARDS) in rheumatoid arthritis (RA) and spondyloarthritis (SpA) results in increased disease activity and symptoms and poorer quality of life. We aimed to describe patients' attitudes and experiences of DMARDs in RA and SpA to inform strategies to improve medication adherence.

methodsDatabases (MEDLINE, Embase, PsycINFO, and CINAHL) were searched to January 2016. Thematic synthesis was used to analyze the findings.

resultsFrom 56 studies involving 1,383 adult patients (RA [n = 1,149], SpA [n = 191], not specified [n = 43]), we identified 6 themes (with subthemes): intensifying disease identity (severity of sudden pharmacotherapy, signifying deteriorating health, daunting lifelong therapy), distressing uncertainties and consequences (poisoning the body, doubting efficacy, conflicting and confusing advice, prognostic uncertainty with changing treatment regimens), powerful social influences (swayed by others' experiences, partnering with physicians, maintaining roles, confidence in comprehensive and ongoing care, valuing peer support), privilege and right of access to biologic agents (expensive medications must be better, right to receive a biologic agent, fearing dispossession), maintaining control (complete ownership of decision, taking extreme risks, minimizing lifestyle intrusion), and negotiating treatment expectations (miraculous recovery, mediocre benefit, reaching the end of the line).

conclusionPatients perceive DMARDs as strong medications with alarming side effects that intensify their disease identity. Trust and confidence in medical care, positive experiences with DMARDS among other patients, and an expectation that medications will help maintain participation in life can motivate patients to use DMARDs. Creating a supportive environment for patients to voice their concerns may improve treatment satisfaction, adherence, and health outcomes.

Indexed as

Health Knowledge, Attitudes, PracticePatient SatisfactionAdultAgedAged, 80 and overAntirheumatic AgentsArthritis, RheumatoidCost of IllnessFemaleHumansIllness BehaviorMaleMedication AdherenceMiddle AgedQualitative ResearchRisk FactorsAntirheumatic Agents

Identifiers

PMID28732151
PMCPMC5901029
OpenAlexW2736638310

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.