"The financial impact is depressing and anxiety inducing": A qualitative exploration of the personal financial toll of arthritis

OBJECTIVES: The financial experience faced by working-age people with arthritis include living below the poverty line for many. Financial distress amongst people with arthritis is known to contribute to poorer health outcomes, including high psychological distress and more severe pain. Despite the demonstrated societal cost of arthritis care and management, the personal costs borne by the individual are not well understood. The aim of this study was to explore the perceived financial impacts of living with arthritis amongst younger adults (defined as those aged 18 - 50 years). METHODS: A qualitative descriptive study design was used. Participants with inflammatory arthritis or osteoarthritis were recruited from the community, including urban and rural settings. An interview schedule was developed, informed by existing literature, which was piloted prior to data collection. Deductive and inductive coding techniques were used to identify financial-related themes arising from the data. RESULTS: Semi-structured interviews were conducted with 21 adults (90% female) with a mix of arthritis conditions including rheumatoid arthritis, psoriatic arthritis and osteoarthritis. Four themes were identified: direct arthritis-attributable medical costs, indirect arthritis-attributable costs, insurance and pension costs, and broader financial impacts on the family. Non-subsidised costs were frequently referenced by participants as burdensome, and existed even within the publically-funded Australian healthcare system. CONCLUSION: Adults with arthritis experience significant arthritis-attributable financial burden and related distress. Financial concerns should be actively identified and considered within shared clinical decision making, in order to provide more patient-centred care for these individuals.