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Comparative Study
. 2013 Feb;13(1):42-6.
doi: 10.7861/clinmedicine.13-1-42.

To what extent is NICE guidance on the management of rheumatoid arthritis in adults being implemented in clinical practice? A regional survey

Nicola Tugnet  1 , Fiona Pearce, Sofia Tosounidou, Karen Obrenovic, Nicola Erb, Jonathan Packham, Ravinder Sandhu
Affiliations
Comparative Study

To what extent is NICE guidance on the management of rheumatoid arthritis in adults being implemented in clinical practice? A regional survey

Nicola Tugnet et al. Clin Med (Lond). 2013 Feb.

Abstract

Rheumatoid arthritis (RA) is a chronic disease associated with significant morbidity. The 2009 NICE guidance advises on the management of patients with RA. In this study, we undertook a survey to assess the implementation of the guidance into practice across the Midlands. In total, 19 rheumatology units participated, of which nine have designated early inflammatory arthritis clinics (EIAC). Data for 311 patients with RA attending clinics were collected during a two week period. The median time from symptom onset to first visit was four months. Of the patients, 95.6% were seen within 12 weeks of referral. Of those seen in EIAC, 75.9% had erosions documented on X-rays versus 49.4% of non-EIAC patients. In addition, 57.9% of patients were offered combination disease-modifying antirheumatic drugs (DMARD) therapy in EIAC, versus 30.4% in non-EIAC units. Monthly disease-activity scores were calculated more in patients attending EIAC than non-EIAC units (51.1% versus 25.4%). Based on our results, there is significant regional variation in implementation of the NICE guidance. In addition, patients with RA attending EIACs are more likely to receive a treat-to-target approach.

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Figures

Fig 1.
Fig 1.
Percentage of patients treated with combination disease-modifying antirheumatic drug therapy at each rheumatology unit.
See this image and copyright information in PMC

References

    1. Wolfe F. Mitchell DM. Sibley JT, et al. The mortality of rheumatoid arthritis. Arthritis Rheum. 1994;37:481. doi: 10.1002/art.1780370408. - DOI - PubMed
    1. National Institute of Clinical Excellence (NICE) Clinical Guideline 79. Rheumatoid arthritis: The management of rheumatoid arthritis in adults. London: NICE; 2009.
    1. Barrett EM, Scott DG. Wiles NJ. Symmons DP. The impact of rheumatoid arthritis on employment status in the early years of disease: a UK community-based study. Rheumatology. 2000;39:1403–9. doi: 10.1093/rheumatology/39.12.1403. - DOI - PubMed
    1. National Audit Office. Services for people with rheumatoid arthritis. London: National Audit Office; 2009.
    1. van der Heijde DM. van Leeuwen MA. van Riel PL. van de Putte LB. Radiographic progression on radiographs of hands and feet during the first 3 years of rheumatoid arthritis measured according to Sharp's method (van der Heijde modification) J Rheumatol. 1995;22:1792–6. - PubMed

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