Objective: The care of patients with chronic diseases such as rheumatoid arthritis is increasingly shared between primary health care and hospital specialist teams. Studies that have informed guidelines for the shared care of patients with rheumatoid arthritis have not included patients' perceptions and preferences. The objective of this study was to explore the experiences and views of patients with rheumatoid arthritis concerning the clinical care they had received from general practitioners (GPs) and specialist hospital doctors.
Design: Semi-structured interviews analysed using grounded theory techniques.
Setting and Participants: A purposeful sample of twelve people receiving clinical care from specialist rheumatologists and GPs. All participants had received a diagnosis of rheumatoid arthritis at least two years previously.
Results: Most participants valued regular review by rheumatologists highly, and looked to them for help with all aspects of their arthritis care. They felt that specialists had greater knowledge concerning disease management than GPs, but both groups of doctors were similarly empathic. The GPs' role was perceived to be important mainly in early diagnosis and first referral to the hospital specialist but less so in the provision of continuing care or help with psychosocial issues. Participants valued the accessibility of GP services. Advice from any source about aids and welfare benefits was often haphazard.
Conclusions: People with rheumatoid arthritis prefer to have regular contact with a rheumatologist rather than obtaining care for their arthritis mainly from their GP. This has implications for the move from secondary to primary care.
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