POS0459 Patients Perspective toward Rheumatic and Musculoskeletal Diseases: Insights from a Large-Scale Survey

Background: Rheumatic and musculoskeletal diseases (RMDs) are prevalent among Arabic-speaking patients in the Middle East and North Africa (MENA) region. However, their perspectives on these conditions remain underexplored. This lack of understanding limits the ability to deliver effective and culturally sensitive care. Objectives: To investigate the experiences, concerns, and views of Arabic-speaking patients with RMDs in the MENA region regarding diagnosis, disease knowledge, and interactions with healthcare professionals (HCPs). Methods: A cross-sectional study was conducted utilizing an online survey titled "PRADA" (Patient peRspectives on rheumAtic Diseases in Arabic countries). The PRADA survey was developed using pilot testing with clinimetric sensibility assessment to ensure relevance and clarity, and the Open-Source Metric for Measuring Arabic Narratives (OSMAN) was used to assess readability. To our knowledge, this is the first study to utilize a readability tool for a health survey written in Arabic language. The Checklist for Reporting Internet E-Surveys (CHERRIES) was used to improve the quality of the survey's content. The survey was distributed via social media platforms to Arabic-speaking patients with self-reported RMDs across the MENA region. Collected data included demographics, disease characteristics, medication use, treatment satisfaction factors, perceived causes, and patient concerns. Data were collected anonymously from August to October 2022 and analyzed using descriptive statistics. Ethical approval was obtained from the Ministry of Health in Kuwait. Results: Of the 1050 responses received, 456 were complete and included in the analysis. Most respondents were female (81.4%), with most falling into the 25–34 age group (29.2%) and the 35–44 age group (34.0%) constituting 63.4% of the sample. The most frequently reported diseases were systemic lupus erythematosus (42.5%), rheumatoid arthritis (32.9%), and ankylosing spondylitis (10.5%). Nearly all (97%) used medications within the previous three months, primarily hydroxychloroquine (48.1%), glucocorticosteroids (37.3%), and biologics (27.6%). Key factors influencing treatment satisfaction (Table 1) included pain relief (78.3%), better laboratory test results (64.7%), improved sleep quality (51.8%), and enhancements in mood and mental health (50.2%). Other notable factors were increased physical activity, reduction or discontinuation of steroids, the side effects of treatment, the doctor's reputation and expertise, communication from the medical team, and the opinions and experiences of others regarding the treatment. Patients perceived immune system dysfunction (76.5%), psychological factors (54.8%), genetics (41.7%), and envy (21.1%) as the primary causes of their disease. Other perceived causes included magic (7.9%) and divine punishment for their sins (6.1%). The main concerns reported by patients (Table 2) were fear of disease complications (95.0%), medication side effects (85.3%), and becoming a burden to others (71.1%). Additional concerns included fear of physical disability (64%), issues related to marriage and childbearing (40%), and fear of falling while moving (31%). Two-thirds of respondents (66.7%) had not consulted a practitioner of complementary and alternative medicine, while one-third (33.3%) had. Rheumatologists (83.5%), internet search engines (71.3%), and social media accounts of rheumatologists (63.6%) were the primary sources of information for patients. Conclusion: This survey is the first and largest of its kind in the MENA region, providing important insights into patient perspectives on RMD. It emphasizes the need for a comprehensive and holistic management, enhanced education, and supportive services to improve patient's quality of life. REFERENCES: [1] Al-Ajlouni et al. The burden of musculoskeletal disorders in the Middle East and North Africa (MENA) region: a longitudinal analysis from the global burden of disease dataset 1990-2019. BMC Musculoskelet Disord. 2023;24(1):439. doi: 10.1186/s12891-023-06556-x. [2] Mousavi et al. The burden of rheumatoid arthritis in the Middle East and North Africa region, 1990-2019. Sci Rep. 2022;12(1):19297. doi: 10.1038/s41598-022-22310-0 [3] Alnaqbi et al. Development, sensibility, and reliability of the Toronto Axial Spondyloarthritis Questionnaire in inflammatory bowel disease. J Rheumatol. 2013;40(10):1726-35. doi: 10.3899/jrheum.130048. [4] El-Haj M, Rayson P. OSMAN ― A Novel Arabic Readability Metric. Portorož, Slovenia: European Language Resources Association (ELRA); 2016. p. 250-5. [5] Al-Mehmadi et al. Knowledge of Common Symptoms of Rheumatic Diseases and Causes of Delayed Diagnosis in Saudi Arabia. Patient Prefer Adherence. 2024;18:635-47. doi: 10.2147/ppa.S448999. [6] Ghaddaf et al. Public awareness about arthritic diseases in Saudi Arabia: a systematic review and meta-analysis. Int Orthop. 2023;47(12):3013-29. doi: 10.1007/s00264-023-05725-w. Acknowledgements: Patients who completed the online survey. Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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