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. 2017 Nov 9;38(4):675–682. doi: 10.1007/s00296-017-3855-6

Table 3.

Individual and overarching patient themes related to glucocorticoid therapy

Individual theme name Individual theme definition
Theme A. Glucocorticoids are effective and withdrawal can potentiate a flare
Positive effects of GC Relief at starting treatment after prolonged investigations.
Symptoms improve quickly; feeling of the problem being fixed.
Staying on GC “for ever” may control symptoms
Flaring on reduction of glucocorticoids Withdrawal symptoms on reducing GCs
Flare linked to reducing GCs
Feeling of GC reduction being an “experiment”
Increasing dosages of GCs resolving flares swiftly
Theme B. Description of salient emotional, physical and social effects of glucocorticoid therapy
Change in appearance Significant weight gain
Puffiness and change in facial features
Not recognising oneself
Feeling “weird”
Not able to wear certain clothes
Feeling depressed by change in appearance
Others comments on appearance Partners comments about weight
Family support to lose weight
Family unsupportive or derogatory about weight
Others unable to understand increase in energy with GCs
Looking “well” on GC masking underlying illness to others
Appetite Hunger pains and increase in appetite
Adaptations needed to reduce weight gain Exercise and diet
Diabetes New diabetes and difficult to control established diabetes
Monitoring of blood sugars: painful and intrusive
Skin changes Easy bruising and skin fragility
Sleep disturbance Difficulty getting to sleep/insomnia
Requiring less sleep
Muscle strength Reduced muscle strength
Emotional symptoms Feeling manic or euphoric
Increased energy/hyperactivity
Anxiety
Mood swings
Depression
Effect of personality change on personal life and or work
Theme C. Patient perceptions of balancing the risks and benefits of glucocorticoids
Process of weighing up use of GC Long-term side effects versus short-term death
Body can only take GC for so long
Maintenance dose may be needed long-term
Concern about long-term adverse effects Bone loss
Diabetes
Glaucoma