Factors Influencing the Acceptability of Intra-Articular Corticosteroid Injections among Pakistani Patients with Arthritis

Objective: Toassesspatients' awareness andattitude towardsintra-articulartherapy.Todetermine the frequency of refusal among patients who were offered intra-articularsteroid injections and to identify the variousreasons for this refusal. Method: This was a cross-sectional study done at the Rheumatology CMH Lahore outpatient clinic from 1st June to 31st July 2022. A total of 204 patients 16 years or above who were potential candidates for intraarticular corticosteroids (IACS) or who had received injections in the past were asked about their knowledge, beliefs, and consent for intra-articular injections as per pre-defined questionnaire. Results: Out of the total 204 patients, 34% refused to get the intra-articular injection. Their major concern was fear of injection, dependence, and only temporary pain relief. Consent was directly correlated with disease severity as determined by pain visual analogue score (VAS) and affected activities of daily living (ADLs), and physician guidance (p=0.001). A negative review from a relative or a personal bad experience leads to rejection of IACS (p=0.001). Those who did not have prior knowledge of IACS, and its response variability agreed more (p=0.01). Conclusion: The patients' fear of dependency, partial effectiveness, and pain were major concerns that lead to the refusal of IACS in almost one-third of the patients. Information gathered from different sources apart from doctors misleads the patients.