title: Patient experiences with intensive combination-treatment strategies with glucocorticoids for early rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate patients' experiences with intensive combination-treatment strategies with glucocorticoids (ICTS-GCs) in the early phase of early rheumatoid arthritis (ERA) treatment.
  
  
  METHODS
  We interviewed 26 participants individually, 4-6 months after initiation of ICTS-GCs (t1). Fourteen participants from the same sample took part in one of three focus groups at least 1 year after treatment initiation (t2). Each interview was audio-recorded, literally transcribed and thematically coded.
  
  
  RESULTS
  The participants described concerns and feelings about ICTS-GCs that changed over time; for example, a fear of side effects diminished when the treatment effects were beneficial or expected side effects did not materialize. Moreover, participants indicated additional information needs at t1 and t2. The most used sources of information were healthcare professionals, relatives, and the Internet. Furthermore, participants reported on their relationship with healthcare professionals and the need for trust and reassurance, especially at t1. Lastly, participants described their personal self-management strategies.
  
  
  CONCLUSIONS
  Despite their concerns at treatment initiation, most participants had positive experiences with ICTS-GCs.
  
  
  CONCLUSIONS
  Healthcare professionals should be aware that, in the early phase of treatment, they can address patients' concerns, they are the most important information source, they need to create a relationship of trust, and guide patients in self-management strategies.
authors.affiliation: Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium. Electronic address: Sabrina.meyfroidt@med.kuleuven.be.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Meyfroidt
authors.affiliation: Center for Health Services and Nursing Research, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Rheumatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Van der Elst
authors.affiliation: Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: Diederik
authors.initials: D
authors.lastname: De Cock
authors.affiliation: Rheumatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Joly
authors.affiliation: Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Rheumatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: René
authors.initials: R
authors.lastname: Westhovens
authors.affiliation: Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marlies
authors.initials: M
authors.lastname: Hulscher
authors.affiliation: Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Rheumatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Verschueren
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D061345:Early Medical Intervention; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids
keywords: Early rheumatoid arthritis; Intensive combination-treatment strategies; Patient perspective; Qualitative research