“…Other eight articles in the same category (61.5%) analyzed the consequences of patients' beliefs about drugs on adherence. Although most patients with RA believed their synthetic and biological DMARDS were necessary to preserve joint structures, reduce pain and increase quality of life, levels of concern about side effects were high and related to non-adherence [3,5,15,16,[41][42][43][44]. Beliefs about cause of disease expressed by RA patients in 9 studies (12.1% of articles reporting beliefs) included: hereditarity, stress, unexpressed grief, diet, occupational factors/overwork, lack of exercise, God's will, weather conditions, biological reasons/immune system failure/autoimmunity, accident/chance and karmic explanation (disease caused by past "bad" actions) [18,36,43,[45][46][47][48][49][50].…”