Method: Participants were recruited from rheumatologist and family physician offices, and from newsletters of patient advocacy groups. We conducted in-depth interviews with 38 people (37 women, 1 man), with an RA diagnosis ≤12 months. The interviews were organized around 3 distinct but overlapping areas: 1) Pre-diagnosis symptoms, impact and management; 2) Experiences with health professionals leading up to the diagnosis; 3) Post-diagnosis experiences of symptoms, management and the health care system. Follow-up phone calls were made to check and elaborate on the interview generated data. Analysis was informed by grounded theory and a narrative approach.
Result:Medications were core to people’s disease management. There was a both a reluctance to take medications and a need for them. Participants expressed ambivalence to medication use in a range of ways: 1) They identified an aversion to medications but required them; 2) They accessed information from multiple sources e.g. the Internet, health professionals and social networks, which was wide-ranging and contradictory; 3) There was little perceived opportunity to discuss options and patient knowledge in the rheumatologist consultation 4) There was post diagnosis delay in and resistance to, taking prescribed medications, and a desire to be ‘weaned off’ or reduce medications, but an ongoing search for relief and disease control.
Conclusion: A number of interrelated factors continued to hamper prescribed medication regimens, once diagnosis was confirmed. The obstacles to effective and timely medication treatment illustrated the importance of patient-physician communications. More opportunities for shared decision-making, based on dialogue and exchange of knowledge and information in the rheumatologist consultation may reduce some of the tensions around medication use and facilitate ongoing and effective treatment plans
Disclosure: A. F. Townsend, None; P. M. Adam, None; C. L. Backman, None; L. C. Li, None.