Attitude of rheumatoid arthritis patients to treatment with oral corticosteroids.
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.
Morrison
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E
Department of Rheumatology, Southern General Hospital, South Glasgow University Hospitals NHS Trust, UK. elaine.morrison@SGH.scot.nhs.uk
Crosbie
D
D
Capell
H A
HA
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012737:Sex Factors; D016312:Treatment Refusal
D018501:Antirheumatic Agents; D005938:Glucocorticoids