Nichola's story

Our self-management approach

DMARDs require the use of two therapies together – evidence shows that this can improve efficacy. However, there is also a problem with adherence, and when treatments are not taken together, efficacy can be reduced.

We conducted advisory boards with key healthcare professionals in this area to help determine the level of understanding of the adherence problem and to discuss potential solutions.

Our Self-Management Framework

Our research and understanding of this population uncovered a number of factors impacting their adherence to DMARDs. These included: treatment necessity, treatment understanding, illness coherence and treatment efficacy.     

Our solution

Our Acceptance solution was selected for this program. Consultants and specialist nurses were provided with discussion guides covering the key adherence factors identified through our research. This solution was used during consultations and was given to patients to read and review themselves, post-consultation.

Nichola’s consultant used this discussion guide at her check-up, asking a series of short questions at the start to ascertain what her specific barriers may be. Her responses highlighted that she had not been using the treatment as prescribed – because she had not understood the importance of using the therapies together – and that she had some misunderstandings about her disease.


Having worked in pharma for over eight years, never have I worked on a medical education project that has received such positive feedback from HCPs. These materials focus on a key area of unmet need for rheumatology services” – Client

“There were a couple of [patients] where you thought, ‘oh God, we’ve really not given this person very much information at all…’ People that had been on drugs for five, ten years, were saying, ‘what’s this DMARD thing that they keep talking about?’... So it was quite illuminating” – HCP

“It’s about empowering patients and getting them to start thinking about their disease and treatment and how they can influence that if they need to” – HCP