Background/Purpose: Rheumatoid
arthritis (RA) is a chronic, debilitating condition for which there is no cure.
The RA NarRAtive is a global initiative to identify patient perceptions
regarding barriers to treatment and self-management.

Methods: The
RA NarRAtive initiative is composed of a global advisory panel of 27
rheumatologists and patient advocacy group leaders. An online, patient-based
survey, designed by the working group, was fielded across 13 countries between
September 2014 and January 2015. The results are presented from all respondents
who consented to the online survey.

Results:
Patients from across the spectrum of
disease activity (3,649) were represented, with 37% (1,346) self-reporting moderate/severe
symptoms, while 12% (436) self-reported low disease activity, 4% (156)
remission, and 28% (1,005) RA under control. Only 34% (1,251) described their
current overall health as good/excellent. The median time since diagnosis was 7
years (range <1 to >10 years). The most frequently-cited concerns were
disease progression (67% [2,437]), and impact of RA on quality of life (QoL;
62% [2,266]). Almost 50% reported stopping participation in certain activities and
29% discontinued work due to RA. Almost half of respondents seeing a healthcare
provider (HCP) to manage their RA (48% [1,616/3,378]) acknowledged that dialogue/discussion
with the HCP would help to manage their RA more successfully. However, over
half of all respondents (62% [2,278/3,649]) felt uncomfortable raising concerns
or fears with their HCP. Overall, 76% (2,764/3,649) of respondents received medication
for their RA. Of those taking prescribed medication (2,139), 38% (808) were not
taking this medication exactly as prescribed, although non-compliance rates
varied substantially from 18–64% depending on country. The most frequently-cited
reasons for non-compliance were treatment side-effects (16% [344]) and
inconvenience (15% [320]). Aspects of current, prescribed RA treatment that
patients would most like to change included: number/frequency of medications
(35% [742]); side-effects (34% [728]); access/cost (30% [632]); availability of
monotherapy (25% [533]); alternative to subcutaneous mode of action (18%
[377]); inconvenience/limitations (16% [344]); and mode of administration (12%
[260]). Although 78% (1,674/2,139) of respondents were satisfied with their prescribed
RA treatment, 70% (1,507) expressed a wish for fewer medications, and 56% (1,200)
desired more choice. These patients defined treatment success according to: reduction
of pain and/or swelling (81% [1,733]); improvements in QoL (77% [1,637]); control
of disease progression (46% [992]); and treatment meeting goals/reducing
medication (40% [852]).

Conclusion:
These findings highlight that, while many patients are satisfied with their RA medication,
non-compliance persists and there are many who would like to change certain
aspects of their prescribed treatment. Furthermore, patient-HCP dialogue is
important in the successful management of RA, which is clear as patients define
successful treatment in terms of significant improvements in their overall
symptoms and improvements in QoL.