Background/Purpose: Adults with rheumatoid arthritis (RA) frequently experience functional deficits, disability, and reduced participation in meaningful activities despite improved medical management. Rehabilitation services, including physical therapy and occupational therapy, can address functional challenges, but referral rates and utilization remain low in the United States. The decision-making processes under which rehabilitation is considered and implemented are poorly understood. The purpose of this study was to explore the experiences and perspectives of patients, rheumatologists, and physical therapists regarding the use of rehabilitation for adults with RA.

Methods: This qualitative study used one-on-one semi-structured interviews with adults diagnosed with RA, rheumatologists, and physical therapists. Purposive sampling was employed to recruit participants with diverse experiences. For patients we sampled for a range of functional levels and prior experience with rehabilitation, while for clinicians we sampled for a range of usual practice with physical therapy for patients with RA. Interview transcripts were analyzed using a mixed deductive and inductive coding approach. Reflexive thematic analysis was conducted to identify and refine key themes related to rehabilitation utilization and integration into routine RA care.

Results: Twenty-four patients with RA, six rheumatologists, and six physical therapists were interviewed. Four themes emerged that illustrate barriers to effective integration of rehabilitation into RA care (Table 1): (1) Need for Rehabilitation, (2) Discussion of Rehabilitation, (3) Interprofessional Collaboration and Training Challenges, and (4) Utilization of Rehabilitation. Rheumatologists often prioritized pharmacological management and reserved rehabilitation until later disease stages or severe functional decline, while patients frequently reported a desire for earlier, preventative rehabilitation. Both clinicians and patients reported limited discussions regarding rehabilitation and barriers to utilization. Knowledge gaps, challenges in interprofessional communication, uncertainty about appropriate referral processes among rheumatologists, and limited exposure to rheumatology care among physical therapists also impeded integration.

Conclusion: Our findings highlight a disconnect between patient needs and current clinical practice regarding rehabilitation in RA care. Addressing patient and clinician knowledge gaps, improving interprofessional communication, and developing clear referral pathways may support more effective integration of rehabilitation services and better align care with patient priorities. Future efforts should prioritize the development of educational interventions and care models that facilitate timely, patient-centered access to rehabilitation as part of comprehensive RA care.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/exploration-of-patient-and-clinician-perspectives-on-rehabilitation-in-contemporary-rheumatology-care-for-rheumatoid-arthritis-a-qualitative-study/