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HCPs considered taking a holiday to be most important (15/21 HCPs [71%] vs 49/80 patients [61%]). The greatest discordance between patients and HCPs was for performing everyday activities in the home (52/83 [63%] vs 7/23 [30%], respectively) and having an intimate relationship (45/83 [54%] vs 3/20 [15%], respectively).Discussion Results of this survey in Saudi Arabia indicate that RA has a considerable impact on many aspects of patients’ lives, including relationships, ability to work and career progression, and daily activities. Both patients and HCPs perceived that people without RA have an understanding of the emotional and physical impact of the disease on patients. However, this perception was less common among younger patients. Nearly half of the patients did not work. Many working patients noted a slowing of career progression, despite patients and—to some extent—HCPs reporting that patients felt supported by colleagues in the workplace. Outside of employment, exercising and housework were the most difficult everyday activities to perform. Patients experienced considerable anxiety as a result of RA hindering their ability to perform everyday activities. Aspirations for a future with RA were modest, with patients hoping that the people in their lives would better understand the emotional impact of the disease on their lives.\To understand how RA impacts on patient relationships, the RA Matters survey included questions about how interactions between patients and the people in their lives had changed since their RA diagnosis. In the current study, there were no clear trends towards a perceived positive or negative impact of RA on personal relationships. Indeed, the negative impact of RA on intimacy with a partner appeared less pronounced in the current study than in the European/Canadian survey,14 in which 48% of patients and 78% of HCPs felt the disease had a negative impact on this aspect of relationships (compared with 31% and 14%, respectively, in the current study). A similar proportion of patients in both surveys (44% in the European/Canadian survey, 45% in the current study) felt that RA had a negative impact on inclusion in family and social events, whereas a larger proportion of HCPs in the European/Canadian study (68%) felt this to be the case (compared with 32% in the current study).It is well documented that many patients with RA have difficulty in continuing to work due to complications from the disease, with 27%–47% of patients unable to stay in full-time employment due to RA within approximately 20 years of disease onset.16 In this study, we sought to quantify how RA impacts on the ability of patients to work in Saudi Arabia. Almost half of the patients were not working at the time of completing the questionnaire, and more than one-quarter felt that RA had slowed their career progression; this is slightly higher than career progression results in the European/Canadian survey,14 in which 23% of patients felt that their careers had slowed since their RA diagnosis. This could be partially explained by cultural differences between Arabic and Western countries in terms of attitudes towards women who work. The high proportion of patients who did not work in the current survey is of note, as the ability to work is recognized as an important treatment target in Saudi Arabia In our study, both patients and HCPs felt that colleagues were fairly accommodating in the workplace. These results contrast with the perceived lack of adequate physical or emotional support from colleagues by patients in Europe and Canada.14 The most common obstacles to working for patients with RA in Saudi Arabia were difficulty using hands (52%) and emotional stress (48%). Similar to the current study, the European/Canadian study14 found that difficulty using hands was
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