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The patient perspective on remission in rheumatoid arthritis: 'You've got limits, but you're back to being you again'

van Tuyl, Lilian H D; Hewlett, Sarah; Sadlonova, Martina; Davis, Bev; Flurey, Caroline A; Hoogland, Wijnanda; Kirwan, John; Sanderson, Tessa; van Schaardenburg, Dirkjan; Scholte-Voshaar, Marieke; Smolen, Josef; Stamm, Tanja; Boers, Maarten

The patient perspective on remission in rheumatoid arthritis: 'You've got limits, but you're back to being you again' Thumbnail


Lilian H D van Tuyl

Martina Sadlonova

Bev Davis

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Caroline Flurey
Associate Professor in Men's Health and Long-term Conditions

Wijnanda Hoogland

John Kirwan

Tessa Sanderson

Dirkjan van Schaardenburg

Marieke Scholte-Voshaar

Josef Smolen

Tanja Stamm

Maarten Boers


© 2015, BMJ Publishing Group. All rights reserved. Objectives: The aim of rheumatoid arthritis (RA) treatment is remission. As treatment should be targeted at outcomes relevant to patients, it is important to understand how patients perceive remission, and to assess whether the current definition of remission adequately reflects these perceptions. The objective of this study is to explore the patient perspective on remission in RA. Methods: Nine focus-group discussions in Austria, The Netherlands and UK were conducted, including patients in American College of Rheumatology (ACR)/ European League of Rheumatology (EULAR) remission, self-declared remission and in moderate/high disease activity. Moderators employed a prespecified interview guide helped to engage patients in a discussion on their experience with remission. Inductive thematic analysis was performed within each country, and identified themes were discussed across countries. Results: 47 RA patients (66% women, disease duration 9 years) participated. Three major themes of patient-perceived remission emerged: (1) symptoms would either be absent or strongly reduced, (2) impact of the disease on daily life would diminish by increased independence, ability to do valued activities, improved mood and ability to cope; (3) leading to a return to normality, including work, family role and perception of others. Patients felt the concept of remission was influenced by ageing, side effects of medication, comorbidities, accrued damage to joints and disease duration. Opinions on duration of state, the role of medication and measurement instruments varied widely. Conclusions: Patients characterise remission by the absence or reduction of symptoms, but more directly by decreased daily impact of their condition and the feeling of a return to normality. The next step is to study whether an additional patient-perceived measure of remission may add value to the ACR/EULAR definition of remission.


van Tuyl, L. H. D., Hewlett, S., Sadlonova, M., Davis, B., Flurey, C. A., Hoogland, W., …Boers, M. (2015). The patient perspective on remission in rheumatoid arthritis: 'You've got limits, but you're back to being you again'. Annals of the Rheumatic Diseases, 74(6), 1004-1010.

Journal Article Type Article
Publication Date Jun 1, 2015
Deposit Date Sep 11, 2015
Publicly Available Date Jun 15, 2016
Journal Annals of the Rheumatic Diseases
Print ISSN 0003-4967
Electronic ISSN 1468-2060
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 74
Issue 6
Pages 1004-1010
Keywords remission, rheumatoid arthritis, patient
Public URL
Publisher URL


Remission_quali_van Tuyl_R2 accepted.doc (168 Kb)

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