The social stigma and health beliefs associated with rheumatoid arthritis (RA) and a fear of medicines being poison may contribute to patients of South Asian origin failing to take their medication and inhabit active involvement in their disease management.
Research undertaken by the University of Manchester studied the factors that influenced behaviour around taking medicines and identified a number of key areas that helped to shape when South Asian patients took their medication:
- Beliefs about the need for medicines in RA
- Fears around the toxicity of medicines
- Traditional remedies versus ‘western’ medicines
- Communication by health professionals
The researchers recommended that South Asian patients with RA would benefit from health professionals giving them tailored information that highlights the long-term consequences of rheumatoid arthritis.
This research has led to a national project between the university and the National Rheumatoid Arthritis Society. The team has set up a project for South Asian patients called ApniJung – ‘our fight’ against RA. The website has relevant patient information on RA in Hindi www.nras.org.uk/apnijung and features South Asian patients telling their stories on RA in Hindi.
Why is targeted information important?
RA is a long-term chronic disease that leads to disability and shorten life expectancy. Uncontrolled disease can have a financial burden on patient, NHS and society.
Not taking RA medicines can have a profound effect on patients’ health and can result in poor clinical outcomes for those with RA.
Our research found that South Asian patients would benefit from tailored advice that highlights the long-term consequences of inadequately controlled RA.
For people from a South Asian background – India, Pakistan or Bangladesh – RA medicines are viewed as culturally unacceptable, making some patients reluctant to start disease modifying anti-rheumatic drugs.
Some patients used traditional and herbal remedies rather than ‘Western’ medicines, believing them to better at tackling illnesses without side effects. Family and friends were often important in deciding whether to take these medicines.
The University of Manchester and the National Rheumatoid Arthritis Society will be developing the website further in collaboration with health professionals and people with RA from South Asian communities all over the UK.
We are creating and developing material in audio-visual format so that it is as accessible as possible for this population which accounts for some 4% of the total UK population. It offers, for the first time, GPs and rheumatology teams, an accessible informative and educational resource for their South Asian patients with RA in Hindi.
- Dr Kanta Kumar is a lecturer at the School of Health Sciences, University of Manchester and Ailsa Bosworth is chief executive of the National Rheumatoid Arthritis Society