Background/Purpose: RA is a chronic, debilitating condition for which there is no cure. To identify and better understand the perspectives of both healthcare providers (HCPs) and patients (pts) regarding RA treatment and management, the RA NarRAtive global advisory panel developed an HCP- and pt-based survey.

Methods: The RA NarRAtive initiative comprises a global advisory panel of 39 RA experts. An HCP-based and a pt-based survey, designed by the working group, were fielded online between Aug 2015 and Oct 2015, and between Sept 2014 and Jan 2016, respectively. Responses are presented from pts treated by a rheumatologist, and HCPs who were rheumatologists in all countries (orthopedists also included in Japan). All respondents are from the same 15 countries.

Results: 3,987 pts responded, of whom 1,667 were managed by a rheumatologist: mean age 51.5 years (yrs), 64% female, median time since diagnosis 7 yrs; respondents represented a wide spectrum of disease activity: moderate to severe (33%; 556) and severe (10%; 159). In total, 1,666 HCPs responded to the survey, 51% were mostly in office- or clinic-based practice and 22% were in mostly hospital- or lab-based practice; mean number of pts with RA that HCPs saw per month was 92.0; HCPs reported that disease activity was moderate to severe in 32.5% of their pts and severe in 17.4%. In the HCP survey, 90% of respondents were satisfied with their communications with pts; however, 68% acknowledged, ‘I wish my pts and I talked more about goals and treatment.’ In the pt survey, 53% of pts acknowledged that dialogue with the HCP would optimize the management of their RA. However, 61% of respondents felt uncomfortable raising concerns or fears to their HCP. 93% of HCP respondents discussed quality of life (QoL) issues with their pts including impact of RA on ability to work, participation in activities, and lifestyle goals. 86% discussed treatment-related issues including adherence to therapy, medication preferences, and whether pts seek treatment from other HCPs. The most common topics that patients reported worrying about and that HCPs believed their patients worry about are similar; although a greater proportion of HCPs believed their pts worry about treatment side effects/failure. HCPs and pts had similar views on what they would most like to change about currently available RA medications, ie severity and number of side effects, cost, and efficacy. RA remission was ranked higher in the HCP survey than in the pt survey as a treatment goal; while pts frequently referred to symptom reduction. Overall, 88% of HCPs agreed that pts who are involved in making treatment decisions tend to be more satisfied with their treatment experience; 74% felt that pts who are not involved are less likely to adhere to treatment. Setting treatment goals with pts and agreement on the treatment plan are considered important by 78% and 79% of HCPs, respectively, as well as being able to have an open dialogue (86%).

Conclusion: Differences between treatment goals set by pts and HCPs were reported, thus highlighting the importance of an open pt-HCP dialogue in the successful management of RA. These findings could help improve adherence and pt satisfaction with their disease management.