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Exploring the remission concept in rheumatoid arthritis with patients and rheumatologists: time for a new approach?

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23

  1. Rheumatology, Hospital General de Villalba, Madrid, Spain.
  2. Department of Rheumatology, Hospital Universitario Puerta de Hierro, Madrid, Spain.
  3. Department of Rheumatology, Hospital Universitario La Paz, Madrid, Spain.
  4. Department of Rheumatology, Hospital Universitario de Sant Joan d'Alacant, Alicante, Spain.
  5. Department of Rheumatology, Complexo Hospitalario Universitario A Coruña, Spain.
  6. Rheumatology, Hospital de Galdacano, Bilbao, Spain.
  7. Department of Rheumatology, Hospital Clínic de Barcelona, Spain.
  8. Department of Rheumatology, Hospital Clínico San Carlos, Madrid, Spain.
  9. Rheumatology, Hospital Universitario de Salamanca, Spain.
  10. Department of Rheumatology, Hospital Universitario de Valme, Sevilla, Spain.
  11. Department of Rheumatology, Joint and Bone Research Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
  12. Rheumatology, Hospital Universitario de Bellvitge, Barcelona, Spain.
  13. Rheumatology, Hospital Universitario de La Princesa, Madrid, Spain.
  14. Rheumatology, Instituto de Investigación Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain.
  15. Rheumatology, Hospital Universitario de León, Spain.
  16. Rheumatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.
  17. Rheumatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
  18. Hospital Universitario de Móstoles, Madrid, Spain.
  19. Institute for Musculoskeletal Health Research, Madrid, Spain.
  20. Institute for Musculoskeletal Health Research, Madrid, Spain.
  21. Institute for Musculoskeletal Health Research, Madrid, Spain.
  22. Pfizer, Medical Department, Madrid, Spain.
  23. Pfizer, Medical Department, Madrid, Spain. maria.montoro@pfizer.com

CER10169 Submission on line
2017 Vol.35, N°5 - PI 0816, PF 0822
Full Papers

Rheumatology Article
Rheumatology Article

 

Abstract

OBJECTIVES:
To explore the remission concept in rheumatoid arthritis (RA) and to compare remission definitions and related concepts between rheumatologists and patients with the purpose of identifying similarities and disparities to comprehend the different perspectives of the disease.
METHODS:
This was a qualitative study of discourse and content analysis through focus groups, conducted from February to March 2016. Four focus groups were set up, each one with different interests: rheumatologists involved in basic research (BR), rheumatologists with high specialisation in imaging techniques (IR), clinical rheumatologists (CR), and patients (PA).
RESULTS:
There is no consensus in a remission definition in RA; differences exist between-groups, rheumatologists and patients value remission differently, and there are discrepancies within the group of rheumatologists. Rheumatologists highlight quantifiable objective parameters, in contrast, patients did not consider objective measures as the best instruments, and they prefer subjective measures of remission. The data confirmed the existence of two sources of knowledge of the disease, technical (physicians) and experiential (patients). These sources of knowledge should concur in order to establish new remission criteria well-adjusted to reality.
CONCLUSIONS:
The lack of consensus between key groups implicated in defining remission and remission criteria suggests a new strategy for its operational definition. Our group proposes that subjects with a balance between experiential and technical knowledge, should be the ones in charge of this assignment.

PMID: 28516881 [PubMed]

Received: 11/12/2016 - Accepted : 06/02/2017 - In Press: 08/05/2017 - Published: 15/09/2017