Winter 2022 (Volume 32, Number 4)

Making Medication Decisions for Family Planning and Pregnancy Among Women with Rheumatoid Arthritis (the MOTHERS Study)

By Mary De Vera, PhD

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About the MOTHERS Study
The MOTHERS Study (Making Medication Decisions for Family Planning and Pregnancy Among Women with Rheumatoid Arthritis) was submitted to the 2019 CIORA Competition with the goal of addressing the question: How do females with rheumatoid arthritis (RA) make decisions related to medication use during pregnancy? It was important to address this question in response to our prior research. First, when we qualitatively analyzed threads on the social news website, Reddit, we found that female patients with RA shared challenges regarding finding information about taking medications during pregnancy and shared anxieties about making these kinds of decisions.¹ Furthermore, when we assessed perinatal medication use patterns among females with RA using administrative health data in B.C., we found substantial discontinuation of biologic originator (bo) disease-modifying anti-rheumatic drugs (DMARDs) (up to 69.5%) and conventional synthetic (cs) DMARDs (up to 59.1%) within the first trimester of pregnancy.² Understanding the treatment decision-making process during pregnancy among women with RA is needed to address these translation and information gaps and support healthy pregnancies.

Conducting the MOTHERS Study During the COVID-19 Pandemic
For the MOTHERS Study, we planned to conduct focus groups among females who were aged 18 years or older; had been diagnosed with RA; and were able to communicate in English and/or French. While we originally planned in-person focus groups in the Lower Mainland of British Columbia, with the onset of the COVID-19 pandemic in the midst of our recruitment and data collection, we pivoted to virtual focus groups. This transition to virtual focus groups proved to be a blessing in disguise that allowed us to include females with RA in other Canadian cities and provinces and had the overall effect of enriching and enhancing representation in the research.

From MOTHERS to PARTNERS
During focus groups, participants in the MOTHERS study emphasized the important roles their partners played. Participants not only suggested that we also gather perspectives from their partners, but they also offered to recruit and invite them to such a study. From these suggestions came the related PARTNERS Study (Perspectives and Experiences Making Family Planning and Pregnancy Decisions of Partners of Women with Rheumatoid Arthritis).

Knowledge Translation
From the MOTHERS and PARTNERS studies, we learned of the complexities of medication decision making for patients with RA and the roles and perspectives of their partners. We presented findings at the 2021 American College of Rheumatology Conference and in resultant peerreviewed publications which are available open access, and we encourage everyone to read and find out more about these complexities and how patients and partners may be better supported by providers.

Website Links
For more information on the MOTHERS study, visit arthritis-research.biomedcentral.com/articles/10.1186/s13075-021-02704-7 and for information regarding the PARTNERS study visit academic.oup.com/rheumap/article/5/3/rkab040/6307276.

Mary De Vera, PhD
Associate Professor, Faculty of Pharmaceutical Sciences,
University of British Columbia
Vancouver, British Columbia

References:

1. Chew C, Rebic N, Baldwin C, et al. “r/Thritis”, Pregnancy, and Parenting: A Qualitative Descriptive Study of Reddit Forums to Explore Information Needs and Concerns of Women With Rheumatoid Arthritis. ACR Open Rheumatology. 2019;1(8):485-492.

2. Rebic N, Sayre EC, Zusman EZ, et al. Perinatal Use and Discontinuation of Disease-modifying Antirheumatic Drugs and Biologics in Women with Rheumatoid Arthritis: a Cohort Study. Rheumatology (Oxford). 2019:kez478.