Table 2 Random examples of accounts of met and unmet expectations of 6/18 patients who commenced on combination therapy

‘I thought it could not work for me, but in fact it did, the most scaring thing for me was not being able to walk or not being able to do anything. But now… I can do a lot of things that I could not do before, well, housework, vacuum cleaning, cooking, and a lot of few bits that I am happy to do. (Patient 4, established RA)

‘I am a bit disappointed now, the pain is sort of coming back more strongly now; and I had my jab [steroid injection] today…I find it difficult to walk, and my ankles get weak and in my fingers I don’t have the strength’. (Pilot Patient 1, established RA)

‘My main expectations are: being able to sleep through the night and not being woken at 3am in the morning in pain, ability to work, I have to function and clarity of mind; I suppose that these are the important improvements I expect from the treatment’. (Patient 7, established RA)

‘I was expecting to get better, like giving me more freedom with my health, mobility is the main thing and I think if you are in pain your mood is different and it changes, you feel you are not well yourself’. (Patient 3, early RA)

‘When I started taking the medicines at the beginning, they started working immediately. I thought I would feel better very, very soon and it happened [mobility fatigue], so I think all my expectations were met’. (Patient 12, established RA)

‘The combination therapy has helped, but not as much as I hoped it would. I think I was hoping for a miraculous change [pain, mobility] and it did not happen’. (Patient 8, established RA)