Rheumatology Advance Access originally published online on June 27, 2003
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Rheumatology 2003; 42: 1247-1250
© 2003 British Society for Rheumatology
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Attitude of rheumatoid arthritis patients to treatment with oral corticosteroids
Department of Rheumatology, Southern General Hospital and 1Centre for Rheumatic Disease, Royal Infirmary, Glasgow, UK.
Correspondence to:
E. Morrison, Department of Rheumatology, Southern General Hospital, South Glasgow University Hospitals NHS Trust, 1345 Govan Road, Glasgow G51 4TF, UK. E-mail: elaine.morrison{at}SGH.scot.nhs.uk
Objective. To assess the attitudes of rheumatoid arthritis (RA) patients to oral corticosteroid treatment, factors influencing these views and their likely clinical impact.
Methods. A cross-sectional survey of 158 consecutive RA out-patients was carried out at two centres over 2 weeks. Demography, disease duration, function [Health Assessment Questionnaire (HAQ)], erythrocyte sedimentation rate (ESR), years of formal education and social deprivation index were noted. Prospective recruitment into the multicentre West of Scotland Early Rheumatoid Arthritis Corticosteroid Trial (WOSERACT) was monitored and reasons for refusal to participate (when available) were noted at three of the centres.
Results. Forty-eight (32%) patients were willing to be treated with oral corticosteroid and 100 (68%) were not. The former were older (P = 0.002), had a higher ESR (P = 0.007), poorer function (P = 0.001) and greater previous exposure to disease-modifying anti-rheumatic drugs (P = 0.013). Ninety patients refused to participate in WOSERACT, in 46 cases (40 female, 6 male) the reason being concerns about corticosteroids.
Conclusions. This study shows a high level of concern about and refusal of corticosteroid treatment in RA, due mainly to patient concerns about adverse effects. Rheumatologists need to be aware of these attitudes as they are likely to affect prescribing.
KEY WORDS: Rheumatoid arthritis, Corticosteroid treatment, Patient attitudes, Corticosteroid side-effects, Study recruitment.
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