Evidence map›Paper›PMID 38966397›Full record

ArticleRheumatology advances in practice2024

Management of refractory disease and persistent symptoms in inflammatory arthritis: qualitative framework analysis of interviews with patients and healthcare professionals.

Hema Chaplin, Carol Simpson, Kate Wilkins, Jessica Meehan, Nora Ng, James Galloway, Ian C Scott, Debajit Sen, Rachel Tattersall, Rona Moss-Morris and 2 more

Abstract read
In one paragraph

Article in Rheumatology advances in practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

12 authors.

Hema ChaplinHealth Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0002-9402-9669
Carol SimpsonCentre for Rheumatic Diseases, Department of Inflammation Biology, King's College London, London, UK.
Kate WilkinsCentre for Rheumatic Diseases, Department of Inflammation Biology, King's College London, London, UK.
Jessica MeehanHealth Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Nora NgRheumatology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
James GallowayCentre for Rheumatic Diseases, Department of Inflammation Biology, King's College London, London, UK.ORCID https://orcid.org/0000-0002-1230-2781
Ian C ScottPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.ORCID https://orcid.org/0000-0002-1268-9808
Debajit SenRheumatology Department, University College London Hospitals NHS Foundation Trust, London, UK.
Rachel TattersallRheumatology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Rona Moss-MorrisHealth Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Heidi LemppCentre for Rheumatic Diseases, Department of Inflammation Biology, King's College London, London, UK.
Sam NortonHealth Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0003-1714-9963

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: This study aims to explore patients' and clinicians' experiences in managing and living with refractory disease (RD) and persistent physical and emotional symptoms (PPES) in patients with RA or polyarticular JIA from their perspectives through interviews and/or focus groups. Methods: A qualitative exploration with 25 patients and 32 multidisciplinary rheumatology healthcare professionals (HCPs) was conducted to obtain participants respective understanding and experiences of managing RD/PPES and its impact on the patient-professional relationship. A pragmatic epistemology approach with framework analysis was employed. Results: Four key themes were identified from both patients and professionals in the management of RD/PPES: risk/perpetuating factors/triggers; need for a patient-centred holistic approach to care, diagnosis and treatment; discordance and impact on the patient-practitioner relationship and current problems in managing RD/PPES. These themes covered 22 subthemes, with none being patient specific and seven being HCP specific. Suggestions for potential management strategies were highlighted throughout, such as involving other specialties or a multidisciplinary team, assessing/treating patient-reported outcome measures and psychosocial factors, patient (re)education, need for adjustments/aids or adaptations, checking the diagnosis and further investigations/imaging and optimizing medications. Conclusion: Management strategies need to be developed that enable appropriate treatment plans for those with RD/PPES that account for wider biopsychosocial factors beyond inflammation and reduce discordance in the patient-practitioner relationship.

Indexed as

multidisciplinary teampersistent symptomspolyarticular JIAqualitativerefractoryrheumatoid arthritis

Identifiers

PMID38966397
PMCPMC11223812

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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.