Understanding barriers and facilitators to effective disease-management in Rheumatoid Arthritis to prevent refractory disease


There is a pressing need to understand the social dimensions that add to disease burden in rheumatoid arthritis (RA) and potential synergistic interactions with biological parameters of disease, such as level of inflammation. The overarching aim of this study is to gather in-depth information on social determinants that drive refractory disease in RA, which could be used alongside ‘traditional’ disease management (i.e. drug therapy), to inform resource allocation and service redesign in line with national standards.

Facts and Figures

Project Lead
E Nikiphorou
King's College London
FOREUM research grant: € 200.000

Meet the Team

Project Lead

E Nikiphorou
King's College London
A Cope
King's College London
R Williams
King's College London
M Buch
University of Manchester


  • To identify the most relevant social determinants of treatment outcomes in RA.
  • To quantify the proportion of refractory RA attributable to social determinants.


  • Month 3-6: ethics application and data access (Phase IIa) approvals
  • Month 12: Completion of qualitative study and questionnaire design for Phase IIa
  • Month 30: Cross-sectional survey data collection
  • Month 36: Data analysis, final reports/publications and dissemination

Patient Voice

This study will provide a deep understanding into non-biological, social factors that drive active disease. This way, the study will provide evidence on how to best combine health and social resources to improve the care pathway of patients with RA, ensuring fair and equal access to all.

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