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Globally, the age-standardized prevalence and incidence rates of RA are increasing each year.4 RA is a disabling disease that has both physical and psychological impacts on patients, leading to reduced health-related quality of life and a negative effect on the course of the disease.5,6 Despite this impact on the quality of life, a survey of rheumatologists in Saudi Arabia found that only 41% of respondents used tools to measure patient physical function and quality of life in daily clinical practice.7Recent studies have highlighted the importance of understanding how the burden of disease affects each individual patient.8 Patient-reported outcomes (PROs) are important tools for healthcare providers (HCPs) as they aid in assessing a patient’s response to treatment8,9 and provide a more patient-centered approach to treatment.10 The importance of understanding patients’ perceptions was highlighted in a recent real-world study that found that three-quarters of patients with RA were unhappy with their treatment despite the majority having received biologic disease-modifying antirheumatic drugs.11 It is also important to obtain the views of both patients with RA and HCPs, as previous observations have shown that there can be discordance between rheumatologists and patients on disease severity and how to manage it.The majority of studies assessing PROs in patients with RA have been carried out in Western populations, and no published studies have yet explored the burden of RA in patients from Saudi Arabia. Therefore, we conducted a survey of patients with RA and HCPs in Saudi Arabia to better understand how the disease affects the lives of patients in this country from the perception of both patients and HCPs.Patients and Method Survey Development and Survey Population An online survey of adult patients (aged ≥18 years) with a diagnosis of RA and rheumatologists or HCPs involved in managing patients with the disease was conducted in Saudi Arabia between January 24 and June 4, 2018. The survey was developed by Weber Shandwick, a global public relations company, and Eli Lilly and Company with guidance from KRC Research, a global public opinion research consultancy commissioned by Eli Lilly and Company. The survey was carried out by KRC Research.The survey design was informed by an exploratory survey among patients prior to the full survey. The full survey used closed-ended questions with nominal and interval scales comparable to those in a similar survey conducted among patients with RA and HCPs in selected European countries and Canada14 in 2017 as a part of Eli Lilly and Company’s RA Matters campaign. The current survey sample was procured through several channels, including social media, RA support groups, and the RA Matters website (https://www.ramatters.eu/). Patients were invited to participate through an RA support group, the Charitable Association of Rheumatic Diseases, and HCPs were contacted directly by KRC Research.Respondents were screened prior to the full survey using a screener questionnaire, and only adults diagnosed with RA by a rheumatologist or HCP with experience in the management of RA were included in the study. Demographic information was also collected in the screening questionnaire. Patients and HCPs were not required to be directly paired. Patients and HCPs were provided with nearly identical surveys, except that HCPs were asked how they believed their patients were affected by RA. Both English and Arabic versions of questionnaires were available.The study was conducted according to the Declaration of Helsinki as revised in Brazil in 2013 and was approved by the Institutional Review Board at King Saud University (Research Project no. E-20-5013). All subjects signed an electronic consent form prior to study
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