Care-seeking pathways, care challenges, and coping experiences of rural women living with rheumatoid arthritis in Odisha, India

Sahoo, Krushna Chandra; Samal, Mousumi; Jena, Sunita; Mahapatra, Pranab; Sutar, Deepika; Das, B. K.

doi:10.1017/s146342361900032x

Cited by 15 publications

(32 citation statements)

References 19 publications

(26 reference statements)

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“…The true magnitude could even be greater given the lower healthcare-seeking by females in India. [ 27 28 ] Few studies, similar to our results, have demonstrated increased risk of multimorbidity among females. Further, some of these child-bearing age group women may become pregnant.…”

Section: Discussionsupporting

confidence: 88%

Profile of multimorbidity in outpatients attending public healthcare settings

Sinha¹,

Panda

Puri

et al. 2021

Journal of Family Medicine and Primary Care

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Background: Multimorbidity, the co-occurrence of two or more long-term conditions (LTC) in individuals, is associated with greater healthcare utilization, expenditure, and premature mortality, thus positing a challenge for patients and healthcare providers. Given its sparsely available epidemiological evidence, we aimed to describe the profile of multimorbidity in a representative sample of public healthcare outpatients in India. Methods: A facility-based cross-sectional study was conducted from 1 st July to 31 st December 2015 in Odisha, India. Fifteen public healthcare facilities were selected by stratified random sampling. Data was collected from 1,870 adult outpatients attending these settings using Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC) tool. Result: Nearly 3/4 th of both women and men outpatients were either obese or overweight. >1/2 had multimorbidity (≥2 LTC) while 1/3 rd had ≥3 LTC. Most prevalent condition was hypertension (63%), followed by chronic backache and arthritis. Cancer and psychiatric illness were least reported. Multimorbidity increased with age group, socioeconomic status, and education level. Females across all age groups had higher reported multimorbidity than males. Diabetes--hypertension was frequently occurring dyad. Both physical and mental component of quality of life was reduced in multimorbidity. Conclusion: Multimorbidity is becoming a norm in healthcare practice with high prevalence in females and older adults. Health services for non-communicable diseases need to include commonly occurring dyads along with health promotion. Higher prevalence in females reinforces the need to incorporate gender differences while studying multimorbidity. Analysis of multimorbidity epidemiology through an equity lens could illuminate the underpinning complexities and heterogeneities of this phenomenon.

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Section: Discussionsupporting

confidence: 88%

Profile of multimorbidity in outpatients attending public healthcare settings

Sinha¹,

Panda

Puri

et al. 2021

Journal of Family Medicine and Primary Care

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“…The most common age group for rheumatoid arthritis in Indian women is between the ages of 35 and 45 years, 19 while the median age at first pregnancy among married women in India is 21 years. 20 Thus, RA occurs in a later age group, which might be one of the probable explanations for the low incidence of clubfoot in babies born to RA mothers.…”

Section: Discussionmentioning

confidence: 99%

Bilateral idiopathic club foot in baby of a rheumatoid mother: A rare case report and its management

Agrawal¹,

Inamdar²,

Choudhary³

et al. 2021

IJOR

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Congenital clubfoot has a multifaceted etiology, with several hypotheses offered in its etiopathogenesis. The clubfoot has rarely been reported in babies born to women who have rheumatoid arthritis (RA). We present a rare case of a 31-year-old lady with RA on disease-modifying anti-rheumatoid drugs who delivered a child with bilateral congenital clubfoot. She had previously been using Methotrexate, Hydroxychloroquine, and Sulfasalazine regularly, but Methotrexate was stopped seven months before pregnancy. A full-term female baby was born through the cesarean section with bilateral clubfoot deformity and a modified Pirani score of eight out of 10. The deformity correction was done with the Ponseti serial casting method. The final modified Pirani score was two out of ten. In newborns born to rheumatoid arthritis mothers, the club foot deformity was effectively treated with serial Ponseti corrective casts, as was idiopathic clubfoot in babies born to non-rheumatoid mothers. Our findings validate the Ponseti serial casting method for these kinds of patients.

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“…This study is nested within a larger study on care-seeking behavior for RA (10). A mixed-method explorative study was conducted in a tertiary care medical college and hospital (SCB Medical College) at Cuttack, Odisha, India.…”

Section: Methodsmentioning

confidence: 99%

Use of Animal and Animal Products for Rheumatoid Arthritis Treatment: An Explorative Study in Odisha, India

et al. 2020

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Severe fatigue, pain, deformity, and disability, are the major concerns for rheumatoid arthritis (RA). The extreme pain experienced by the patients often force them to experiment with various indigenous substances including animals and animal products. However, there is little evidence on the use of animals or animal products as traditional medicine in RA. Hence, this study was aimed to explore the experience and perception of patients toward the use of animals and animal products for the treatment of RA. A qualitative, explorative study was conducted at the outpatient department of Rheumatology of a tertiary care medical college and hospital at Cuttack, Odisha, India. Out of 113 patients with RA, 18 patients gave history of use of animal and/or animal products and were selected for in-depth interviews. The content analysis methods were used for data analysis. Four major categories emerged: (1) prevailing patterns of traditional treatment of RA using animals, (2) beliefs and values behind the traditional treatment of RA, (3) sources and traditional learning pathway of indigenous practices on RA, and (4) ethical aspects of the indigenous practice of using animals and/or animal products in the treatment of RA. This study revealed the practice of eating dead animals to get relief from RA. However, there was hardly any perceived positive outcome of the practice; which indicates the lack of awareness of rational, scientific, treatment, and prevalence of irrational and unethical practices for the treatment of RA. Hence, community awareness, social mobilization, and newer screening tools are necessary to improve the timely detection and prevention of irrational treatment practices among RA patients.

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Care-seeking pathways, care challenges, and coping experiences of rural women living with rheumatoid arthritis in Odisha, India

Cited by 15 publications

References 19 publications

Profile of multimorbidity in outpatients attending public healthcare settings

Profile of multimorbidity in outpatients attending public healthcare settings

Bilateral idiopathic club foot in baby of a rheumatoid mother: A rare case report and its management

Use of Animal and Animal Products for Rheumatoid Arthritis Treatment: An Explorative Study in Odisha, India

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