ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1774

Making Decisions About Medication Use, Pregnancy, and Having Children Among Women with Rheumatoid Arthritis: A Constructivist Grounded Theory Study

Nevena Rebic1, Ria Garg2, Sarah Munro2, Glen Hazlewood3, Neda Amiri2, Nick Bansback2, Stephanie Ensworth2, Corisande Baldwin4, Laurie Proulx5 and Mary De Vera1, 1Arthritis Research Canada, University of British Columbia, Vancouver, BC, Canada, 2University of British Columbia, Vancouver, BC, Canada, 3University of Calgary, Calgary, AB, Canada, 4University of British Columbia, Calgary, AB, Canada, 5Canadian Arthritis Patient Alliance, Ottawa, Canada

Meeting: ACR Convergence 2020

Keywords: Decision analysis, Disease-Modifying Antirheumatic Drugs (Dmards), pregnancy, Qualitative Research, rheumatoid arthritis

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Monday, November 9, 2020

Session Title: Reproductive Issues in Rheumatic Disorders Poster

Session Type: Poster Session D

Session Time: 9:00AM-11:00AM

Background/Purpose: Despite guidelines for managing rheumatoid arthritis (RA) in pregnancy, high rates of discontinuation of disease-modifying anti-rheumatic drugs (DMARDs) considered safe for women with RA during pregnancy may suggest a translation gap of emerging clinical knowledge to patients. We examined the process of making treatment and pregnancy decisions among women with RA.

Methods: Study design. We conducted a mixed-methods qualitative research study. Participants. Through collaborations with rheumatologists and patient partners, we used poster and social media advertisements to recruit a purposive sample of female participants who were 18 years or older, had an RA diagnosis confirmed by a rheumatologist, lived in Canada, and were able to communicate in English or French. Data collection. We collected data through semi-structured focus group and individual interviews using telephone and video conferencing technology. Focus groups were composed of participants with similar pregnancy and medication use experiences. Data analysis. We analysed data using a Constructivist Grounded Theory approach within a feminist theoretical framework, which involved steps of line-by-line coding, focused coding and categorizing, and theoretical coding. Data collection and analysis were iterative and continued until saturation of themes was achieved. 

Results: We recruited 22 participants across Canada who had a mean age of 34 years, median 7 years since RA diagnosis, and most (86%) were married or co-habited with a partner. Overall, 36% had never been pregnant, 55% had previously been pregnant, and 9% were pregnant at the time of interview. Of those who had experienced pregnancy, 58% had at least one pregnancy while diagnosed with RA and of those, a further 67% used DMARD(s) during a pregnancy. Over half (55%) reported intending to have future children through childbearing or other means. We constructed a framework (see Figure 1) depicting the dynamic relationships between 4 identified decision-making processes: 1) using medications, 2) having children, 3) planning pregnancy, and 4) parenting. Moreover, we elicited the complex influence of contextual factors on these processes, particularly attitudes towards health and medications, disease onset and severity, familial support system, and healthcare provider relationship.

Conclusion: Our framework provides insight into how women have made reproductive health decisions in the context of managing RA. By understanding the practical and emotional aspects of this process, healthcare providers can identify opportunities for intervention or care adaptation leading to improved health outcomes for women and babies. Our findings demonstrate that a patient-centred approach to care supports women with RA in making better reproductive choices that align with their individual values.

Figure 1. A constructivist, woman-centred, grounded theory framework for making pregnancy and family decisions in relation to living with rheumatoid arthritis. INDIVIDUAL IDENTITY: encompasses a woman’s personal hopes, desires, beliefs, values, and fears about her life. PATIENT IDENTITY: encompasses a woman’s experiences of being a patient, including the timing of disease onset, disease experience and severity, and relationships with healthcare providers. FAMILIAL IDENTITY: encompasses a woman’s experience of being a member of a family, including expectations of motherhood, motherhood experiences, and relationships with family and/or romantic partner(s). Dotted lines: demonstrate that a woman’s identities are fluid, overlapping, and influence one another. Gray shading: demonstrates that medication decisions occur in a dynamic context between a woman’s identities and other decision-making processes.


Disclosure: N. Rebic, None; R. Garg, None; S. Munro, None; G. Hazlewood, None; N. Amiri, None; N. Bansback, None; S. Ensworth, None; C. Baldwin, None; L. Proulx, None; M. De Vera, None.

To cite this abstract in AMA style:

Rebic N, Garg R, Munro S, Hazlewood G, Amiri N, Bansback N, Ensworth S, Baldwin C, Proulx L, De Vera M. Making Decisions About Medication Use, Pregnancy, and Having Children Among Women with Rheumatoid Arthritis: A Constructivist Grounded Theory Study [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/making-decisions-about-medication-use-pregnancy-and-having-children-among-women-with-rheumatoid-arthritis-a-constructivist-grounded-theory-study/. Accessed January 17, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/making-decisions-about-medication-use-pregnancy-and-having-children-among-women-with-rheumatoid-arthritis-a-constructivist-grounded-theory-study/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.