Patients' perceptions of rheumatoid arthritis and their behaviour towards medications in Saudi Arabia: a qualitative study.

Abstract

Background: Medication preferences and associated challenges remain unexplored in Saudi patients with rheumatoid arthritis (RA).

Objectives: To explore the perceptions, beliefs and experiences of patients with RA regarding the disease and its treatment in Saudi Arabia.

Design: Three focus groups were created in Riyadh, Saudi Arabia through purposeful sampling. Discussions were recorded and transcribed. Subsequently, thematic analysis was performed.

Participants: The groups included women, aged 35-50 years (n=6), men (n=4) and women above 50 years (n=5).

Results: The identified themes included stress and losing a loved one as the primary factors inducing RA, delay in diagnosis and beliefs about certain foods that triggered RA flare-ups. The most common adverse effects were weight gain, nausea and fungal infections. The participants were open to starting new medications. Stiffness was the main unmet need among the participants. Adverse effects, pain management and fertility problems were key factors affecting treatment transitions. Younger participants expressed concerns about prices and availability of medications. Physical exercise and therapy were identified as important complementary therapies for improving the quality of life. The lockdown during the pandemic may have positively impacted patients' symptoms. Younger women highlighted challenges related to the transition of treatment before and after contraception, losing their jobs, meeting their children's and family's needs and pursuing their dreams. Men expressed concerns about fertility and a fear of needles. Psychological and social challenges were the main theme among older participants.

Conclusion: This study identified patient preferences and needs that could guide future educational initiatives for physicians and communities.