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Patients' views on the causes of their polymyalgia rheumatica: a content analysis of data from the PMR Cohort Study
  1. Maatla Tshimologo1,
  2. Benjamin Saunders1,
  3. Sara Muller1,
  4. Christian D Mallen1,
  5. Samantha L Hider1,2
  1. 1Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
  2. 2Department of Rheumatology, Haywood Hospital, Keele, UK
  1. Correspondence to Dr Benjamin Saunders; b.saunders{at}


Objective To explore primary care polymyalgia rheumatica (PMR) patient beliefs about the causes of their PMR.

Design Qualitative content analysis was conducted on patients' written responses to the question of what they thought had caused their PMR. All data were coded and emergent categories of causal beliefs identified.

Setting Community patients receiving primary care at general practitioner (GP) practices across England.

Participants Participants were recruited from a primary care PMR inception cohort (n=654). Between June 2012 and June 2014 GPs referred 739 people with a new PMR diagnosis in the past 3 years into the study. Patients were mailed a baseline self-completion questionnaire, which included the question, ‘What do you think caused your PMR?’. Responses to this question form the data set for the present study.

Results 296 (45%) patients gave a possible cause for their PMR, while 276 (42%) respondents wrote ‘no idea’. Common attributions include ageing (45, 18%), medication (18, 5%) and personal stress (53, 14%). 24 respondents (6%) thought their PMR was as a result of another medical condition.

Conclusions This is the first study to examine causation beliefs in PMR, identifying a number of possible causes such as ageing, stress and as a complication of other medical problems. Understanding these patient beliefs may impact on treatment adherence and patient outcome.

  • Patient beliefs
  • Polymyalgia rheumatica
  • Content analysis

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  • Contributors MT analysed all of the data and wrote the manuscript. BS contributed to data analysis and to the writing of the manuscript. SM conceptualised and developed the idea for the study as part of the broader research programme, contributed to data analysis and to the writing of the manuscript. CDM developed the idea for the study, contributed to data analysis and to the writing of the manuscript. SLH developed the idea for the study, contributed to data analysis and to the writing of the manuscript. All authors critically edited the manuscript and read and approved the final version.

  • Funding This work was supported by an Arthritis Research UK Clinician Scientist Award received by CDM who funded the PMR Cohort Study (grant number 19634). MT was funded to carry out the present research through an INSPIRE summer studentship. CDM is funded by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care West Midlands, the NIHR School for Primary Care Research and a NIHR Research Professorship in General Practice (NIHR-RP-2014-04-026).

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Ethics approval Ethical approval for the study was received from the Staffordshire Local Research Ethics Committee (REC reference number: 12/WM/0021).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.