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Area of Science:

  • Rheumatology
  • Patient-Reported Outcomes
  • Qualitative Research

Background:

  • Methotrexate (MTX) is a common treatment for rheumatoid arthritis (RA).
  • An estimated 11%-33% of RA patients experience intolerance to MTX.
  • Patient intolerance often leads to medication discontinuation or changes, impacting RA management.

Purpose of the Study:

  • To describe methotrexate intolerance from the patient's perspective.
  • To explore the complex belief systems underlying patient intolerance to MTX.
  • To define the patient's unique viewpoint on MTX intolerance in RA.

Main Methods:

  • Descriptive qualitative methodology.
  • Semistructured, audio-recorded individual interviews.
  • 14 adult English-speaking RA patients who have taken or are taking MTX.

Main Results:

  • Methotrexate intolerance is characterized by a complex belief system.
  • Three key themes emerged: beliefs about MTX risks, MTX benefits, and RA threat.
  • Patients weigh perceived MTX risks/benefits against perceived RA risks.

Conclusions:

  • Patient perspective on MTX intolerance is crucial and poorly defined.
  • Understanding patient beliefs is essential for managing MTX intolerance in RA.
  • This study elucidates the critical underpinnings of patient-reported MTX intolerance.