Beliefs, preferences, and informational needs of patients with rheumatoid arthritis and concomitant cancer: a qualitative study

Treatment of rheumatoid arthritis (RA) with biologic drugs in patients with cancer could potentially result in poor cancer outcomes. This study aimed to identify the beliefs, preferences, and informational needs of patients with RA and cancer regarding the harms, benefits, and uncertainties surrounding the use of RA therapy with respect to cancer.

We interviewed 20 patients with RA and cancer recruited from a cancer center using a semi-structured guide. We explored patients’ discussions with physicians, beliefs, preferences about RA treatment, and decision-making issues. Using a deductive approach, patients’ responses were grouped according to the explored themes.

Fifteen (75%) patients were women; mean age was 59.9 years (standard deviation, 9.8). Patients discussed RA symptoms, adverse events, drug interactions, and discontinuation of RA treatment after cancer diagnosis; most felt their concerns were clarified after the discussion with their physicians. Some patients were concerned about the risk of cancer development or recurrence due to RA treatment; few were concerned about the interaction between RA and cancer treatment. Patients were concerned about the impact of cancer treatment on RA and potential immunosuppression. Patients relied on discussions with their physician and their own previous experiences to make decisions. Most patients would consider taking a drug for RA even when its impact on cancer is unknown. Patients wanted to receive information about drugs’ efficacy and adverse effects, drug interactions, impact of RA drugs on cancer, and costs.

Our findings on informational needs, concerns, information delivery preferences, and desired level of involvement in the treatment-related decisions of patients with RA and cancer can facilitate the development of educational material that can help with shared decision-making in patients with RA and cancer. We identified important aspects related to the informational needs and concerns of patients with RA and cancer, including worries about not being able to receive RA treatment.

Not applicable.