Exploring the Barriers and Facilitators to accessing and engaging with information resources about Rheumatoid Arthritis (RA) by ethnic minority or non-native patients: A Systematic Review and Thematic Synthesis.

Objectives: To synthesise existing literature describing barriers and facilitators to accessing and engaging with rheumatoid arthritis (RA) self-management information by non-native and ethnic minority groups.

Methods: Four electronic databases were searched inception-2024 and screened by two independent reviewers against prespecified inclusion criteria: 1. Participants with RA and non-English language speakers; 2. Included adults. 3. Qualitative design. 4. Address the research question. Thomas and Harden’s method for thematic synthesis was applied with line-by-line coding of findings, using NVivo software. Codes were grouped to represent commonly described themes and sub-themes of key concepts. The themes were discussed and modified among the wider research team. Quality appraisal by two independent reviewers used the CASP checklist, assessing methodological rigour and the validity of results to identify potential sources of bias.

Results: Eight studies were included, with three main themes identified: 1) Lack of awareness, knowledge and understanding of RA and its treatments, 2) Mistrust of healthcare professionals, 3) Uncertainties and concerns regarding risks and benefits of treatments, impacting adherence. Cultural differences and stigma among non-native and ethnic minority patients added challenges to patient-provider interactions. Insufficient information caused fears of medication side effects, reducing adherence. Language barriers and poor communication eroded trust, leaving patients feeling isolated. This cycle of delayed treatment and poor adherence impacted RA management and quality of life.

Limitations include that many studies focused on healthcare interactions and patient preferences in RA, often emphasising healthcare professionals rather than patients. Some included other diseases like Lupus, or only English speakers, complicating data extraction.

Conclusion: Collective evidence suggests that ethnic minority and non-native patients encountered barriers to accessing information about RA, likely impacting patients’ overall health outcomes. Future work should focus on designing and delivering better educational resources for non-native and ethnic minority individuals with RA, to ensure that information is accessible and equitable.