What is RAPID?

The Rheumatoid Arthritis the Public InformeD (RAPID) project is collaborative research between researchers from the University of Birmingham (Prof Karim Raza, Dr Rebecca Stack, Sister Kanta Kumar & Dr Gwenda Simons) and the University of Keele (Prof Christian Mallen) and will explore the perceptions of Rheumatoid Arthritis (RA) amongst members of the general public, their knowledge of RA and their reaction to the presentation of RA symptoms.

Rheumatoid Arthritis (RA) is a chronic condition which has a profound impact on the life of those suffering with it. It causes inflammation of the joints which can lead on to joint destruction. Rheumatoid Arthritis can occur in people of all ages, although onset is most frequent between the ages of 40 and 60. According to the National Rheumatoid Arthritis Society (NRAS) it currently affects approximately 580,000 people in England alone (http://www.nras.org.uk/).

Treatments have improved greatly over the years and now help many of those affected. It has been shown that if people with RA are diagnosed early and treated with disease modifying anti-rheumatic drugs (DMARDs), they are likely to have a better outcome in the future (e.g. less joint destruction and less disability). Unfortunately, people often wait for a long time before seeking help for (initial) RA symptoms, missing this vital treatment window. If the diagnosis and treatment of RA are delayed, irreversible joint destruction and disability can occur.

Aims of the RAPID project...

Through the RAPID project we will find out why people do not seek help for their symptoms when they begin. We are investigating perceptions and knowledge of RA in the general public (people without RA) and are looking at how they would respond to experiencing the first symptoms of RA. We aim to explore:

1) what members of the public know about RA

2) how they perceive this condition and

3) the triggers they may use to seek help from health care professionals

What the project entails...

Whilst previous research has looked at the reasons why patients might delay help-seeking retrospectively, by interviewing and surveying people with established RA, the RAPID project investigated perceptions and knowledge of RA amongst members of the general public without RA. Using interviews and surveys we further looked at how people would respond to experiencing the first symptoms of RA and investigated why people might or might not seek help for the symptoms of RA. Comparisons were also made with other illnesses such as bowel cancer and angina to understand better whether certain symptoms are easier to recognise and are associated with more rapid help seeking than others.

This research has given us a better understanding of how people might react when they are in the very early stages of RA, something which might be difficult for patients to remember retrospectively. The findings show that people often fail to recognise their symptoms as being indicative of a serious underlying condition. For example, symptoms are often confused with those of osteoarthritis or simply ascribed to getting older. The symptoms of diseases such as bowel cancer and angina on the other hand, are readily recognised and deemed serious enough to seek help promptly. Furthermore, due to recent public health campaigns, most people understand the potential consequences of ignoring the symptoms of bowel cancer and angina. It is likely that the misunderstandings surrounding the symptoms of RA will lead people to delay help-seeking.

Two scientific publications based on the interview data are already available and write-ups of the survey data and further interviews are currently underway.

1)     Simons, G, Mason, A, Falahee, M, Kumar, K , Mallen, CD, Raza, K and Stack, R (2016). Qualitative exploration of illness perceptions of Rheumatoid Arthritis in the General Public. Musculoskeletal Care. http://onlinelibrary.wiley.com/doi/10.1002/msc.1135/abstract

2)     Simons, G., Kumar, K., Mallen, C.D., Stack, R.J., &Raza, K. (2015). A Qualitative Investigation of the Barriers to Help-seeking Among Members of the Public Presented with Symptoms of New-onset Rheumatoid Arthritis. The Journal of Rheumatology DOI: 10.3899/jrheum.140913 http://www.jrheum.org/content/42/4/585.long

This research is supported by The Dunhill Medical Trust [grant number R226/1111]

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