AB1425-PARE FAMILY PLANNING IN CHRONIC RHEUMATIC DISEASES: UNMET NEEDS OF WOMEN AND MEN IN SWEDEN
Authors: Li Alemo Munters, Nathalie Holmen, Suzanna Jansson
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Family planning (FP) in the context of chronic rheumatic disease (CRD) can be challenging for both women and men, with additional requirements for information and support.<sup>1</sup> However, it is unclear whether the needs of this population are being met by current clinical practice in Sweden. <h3>Objectives</h3> To gain insight into the perspectives of women and men with different CRDs on FP, and to assess whether they feel adequately supported to make informed decisions. <h3>Methods</h3> A 10-minute survey focusing on participants experiences and current needs around FP was designed. The survey was distributed (24 Aug5 Sept 2018) via a web–based system to members of the Swedish Rheumatism Association; men and women aged 1847 years were included. Data are reported for participants with arthritic or systemic CRDs (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, juvenile idiopathic arthritis, systemic sclerosis, systemic lupus erythematosus, polymyositis, dermatomyositis). Participants with fibromyalgia, Ehlers-Danlos syndrome, other or no CRD were excluded. <h3>Results</h3> Of 944 participants, 542 (57%) women and 60 (6%) men with arthritic or systemic CRDs responded. Over a quarter of women (28%) who had/were expecting children felt their CRD had affected their ability to have children and more than half either believed that their CRD had influenced the number of children they had or were undecided (Figure A). Men were less affected by their CRD with respect to FP, with &gt;60% reporting no impact on their ability to have children and/or how many. Of participants who did not want children/more children in the future, around a third attributed this to their CRD (women: 37% [n=86/232]; men: 30% [n=9/30]). Their biggest concerns were not being able to physically handle and/or cope with taking care of a child, and passing on their disease (<b>Figure B</b>). Womens concerns regarding disease activity after pregnancy were not unfounded, with 66% reporting disease worsening postpartum. The most common treatments reported by women with CRD while trying to conceive were DMARDs (20%), NSAIDs (18%), corticosteroids (14%) and anti-TNFs (13%). Of women on anti-TNF therapy (n=71), 68% discontinued treatment during pregnancy. Only around a third of women felt they had received adequate support and information about FP from their healthcare provider (HCP; 33%) and that this information was consistent between HCPs (28%). Men with CRD were even less satisfied with both the level of support (13%) and the consistency of information received around FP (13%). <h3>Conclusion</h3> The results of this survey suggest that in Sweden, CRD has a marked impact on FP for women, and to a lesser extent for men. Furthermore, the level of support and information on FP provided by HCPs to people with CRD, as well as the consistency of information received from different HCPs, were deemed inadequate. Providing better information on FP by HCPs, to both women and men with CRD, would help to support them on their journey to parenthood and overcome perceived obstacles to having children and continuing therapy. <h3>References</h3> [1] Tincani A. Ann Rheum Dis2018;77:866. <h3>Acknowledgement</h3> We thank the respondents who participated. This study was funded by UCB Pharma, conducted by the Swedish Rheumatism Association, medical writing by Arianna Psichas, Costello Medical, UK. <h3>Disclosure of Interests</h3> Li Alemo Munters: None declared, Nathalie Holmen Employee of: Employee of UCB Pharma, Suzanna Jansson: None declared