¹Ha-Neul Yu,²Rajaie Namas, ⁴Lara N. Memisoglu, ²Bianca Lantajo, ²Annie Joy, ²Manal Ballan, ²Noor Abdul Ghani, ³Safa Hegazin, ²Mohamed Elarabi

¹Biology Program, Division Of Science, New York University Abu Dhabi, ²Cleveland Clinic Abu Dhabi, ³Division of Hospital Medicine, Department of Internal Medicine, Cleveland Clinic Abu Dhabi, ⁴Cleveland Clinic Abu Dhabi

Background:

Knowledge is a vital element in treating patients with rheumatic and musculoskeletal diseases (RMD) which allows the ability to cope with the physical, psychological and social problems associated with the disease burden. In addition, it is essential to the promotion of preference, adherence, compliance, and safety in relation to complex treatment regimes. The aim of the study is to assess the patient awareness on RMD’s and estimate the preference in regards to immunosuppressive therapies in the United Arab Emirates (UAE) population who are attending Cleveland Clinic Abu Dhabi.

Materials and methods:

The study included 2 arms, patients with an established diagnosis of RMD and the patients who were referred to the rheumatology clinic to be screened for an underlying RMD. A self-made questionnaire in 2 languages (English and Arabic) which comprised of 10 questions divided into 2 sets: i) Knowledge on RMDs (gender, level of education, duration of disease, effect on pregnancy, are autoimmune disease curable, and duration patients with the autoimmune disease receive immunosuppressive therapies); ii) Medication preference (oral versus [vs.]. subcutaneous vs. intravenous, daily vs. weekly vs. monthly). Descriptive statistics were used to calculate all participants’ responses. Student t-test for quantitative data and the chi-squared test for qualitative data. p<0.05 was considered significant.

Results:

A total of 455 patients, of which 303 patients had established diagnosis of a RMD (dRMD) and 152 patients screened for underlying rheumatic disease (sRMD), were studied. About 76.7% were females (dRMD: 80.9%; sRMD: 68.4%; p=0.003). Mean age was 43.3±0.7 (dRMD: 41.0±0.8; sRMD: 47.7±1.2; p=0.004). Majority of patients had either College/University/Bachelor’s degree (dRMD: 47.9%; sRMD:54.6%), secondary school (dRMD:18.8%; sRMD:15.1%), and Illiterate (dRMD:6.3%; sRMD:12.5%). The most common rheumatic disease was rheumatoid arthritis (37.3%) followed by SLE (32.7%). There were 63.3% answered that RMDs is a curable disease (dRMD: 64.7%; sRMD:69.7%; p=0.28), 56% answered that RMD affect pregnancy or getting pregnant (dRMD: 53.8%; sRMD:60.5%; p=0.17), 7.7% answered the disease is communicable (dRMD: 6.9%; sRMD:9.2%; p=0.39). 49.9% answered that the disease is lifelong, 20.4%(less than one year), 14.5 (1-2 years) and 15.2% (3-5 years). Patients preferred oral medication (74.9%) over subcutaneous injection (11.6%) or intravenous (13.4%) with the highest preference for the monthly medication (42.9%) followed by daily (32.5%) and weekly (24.6%). The majority of patients involved in the study were educated however they have full awareness about RMDs. There were no differences in understanding RMDs between patients with established rheumatic diseases or patients who were screened. Different education levels had significant differences in responses about whether rheumatic autoimmune diseases can be cured and the duration of treatment in patients with established rheumatic autoimmune diseases.

Conclusion:

These findings highlight the need for raising awareness of rheumatic diseases in our community to promote better understanding and adherence to the treatment regimens in the United Arab Emirates