Patient Expectations of Pharmacological Treatments in Rheumatic Conditions: A Protocol for a Systematic Review

Rheumatic conditions are chronic, progressive diseases that impact over 1.7 billion people globally and require lifelong pharmacological management. While interventions like DMARDs and biologics are central to treatment, patients' expectations regarding efficacy, side effects, and time to improvement significantly influence their adherence and psychological well-being. Current literature frequently prioritises clinical safety and efficacy over psychosocial factors; therefore, this systematic review aims to identify and evaluate evidence regarding adult patients' expectations of these therapies. The primary objective is to determine what patient expectations are in relation to their prescribed pharmacological treatment. The research will identify core themes, such as beliefs about medication necessity and fears of long-term toxicity or immunosuppression. Furthermore, the study will analyse how these expectations vary by age, gender, and condition type, specifically comparing the goals of patients with inflammatory diseases against those with non-inflammatory or chronic pain conditions. By providing a thematic synthesis of existing research, this project expects to improve clinician-patient communication and treatment engagement. The findings will assist healthcare professionals in identifying unrealistic expectations that may lead to dissatisfaction or non-adherence.