Learning to live with RA as an unwelcome companion-patients' experiences after 1 to 2 years of DMARD treatment.

OBJECTIVES: Rheumatoid arthritis (RA) can be life-changing, requiring long-term treatment to control disease activity. It is therefore important to gain knowledge about patients' experiences of living with RA after 1 to 2 years of disease-modifying antirheumatic drug (DMARD) treatment. METHODS: This qualitative study used an inductive approach. Interviews were conducted with 22 patients with RA in 7 focus groups (17 participants) and 5 individual interviews. Participants were 15 women and 7 men, with a median age of 57 years, an RA disease duration of 12 to 21 months, and 12 to 20 months of treatment with conventional synthetic or biological DMARDs. The interviews were analysed using qualitative content analysis. RESULTS: Patients' experiences of living with RA after 1 to 2 years of DMARD treatment reflected a recognition of RA as an unwelcome companion that the patients had learned to live with. The experiences were expressed as: (i) managing daily life despite disease limitations, including struggling with work-life balance and trying to maintain social participation; (ii) reconfiguring the self with disease limitations through feeling unlike oneself, and experiencing changes in bodily appearance and mood; (iii) finding humility despite disease limitations by being grateful for the treatment and making the most of each day. CONCLUSIONS: After 1 to 2 years of DMARD treatment, participants experienced RA as an unwelcome companion, with daily life constrained by physical, psychological, and social demands. Care should therefore extend beyond inflammation control to include person-centred, goal-oriented support and rehabilitation.