Development of the Australian Rheumatology Association Clinical Care Standard for the Diagnosis and Management of Rheumatoid Arthritis in Adults

Maria B Sukkar¹, Rosemary Ainley², Claire Barrett³, Stephanie Bond⁴, Linda A Bradbury⁵, Andrew M Briggs⁶, Angela Brown⁷, Courtney Brown⁸, Rachelle Buchbinder⁹, Lisa Carroll¹⁰, Jessica Cheers⁸, Rebecca Grainger¹¹, Pauline Habib¹², Louise Hardy⁸, Justin J Holland¹³, Tony Hollins¹⁴, Rebecca James¹⁵, Donna Knapp¹⁶, David F L Liew¹⁷, Lyn March¹⁸, David Martens¹⁹, Carol McCrum²⁰, Dennis R Neuen²¹, Jonathan Ong²², Susanna M Proudman²³, Debra Rowett²⁴, Tracey Rudd¹, Sabina Schot²⁵, Marline L Squance²⁶, Deborah E Turner²⁷, Samuel L Whittle²⁸, Shirani A Wright²⁹, Helen Keen³⁰, Catherine L Hill³¹

Affiliations

¹ M.B. Sukkar, PhD, T. Rudd, B.Pharm, Australian Rheumatology Association, Sydney, Australia.
² R. Ainley, Dip. Bus. Admin., CreakyJoints Australia, and Global Healthy Living Foundation Australia, Chatswood, and Young Women's Arthritis Support Group Australia, and Sydney Partnership for Health, Education, Research and Enterprise, Musculoskeletal Health Clinical Academic Group, Consumer Community Council, Sydney, Australia.
³ C. Barrett, MBBS, Faculty of Medicine, University of Queensland Medical School, Brisbane, and Rheumatology Unit, Redcliffe Hospital, Redcliffe, Australia.
⁴ S. Bond, MBBS, Department of Rheumatology, St Vincent's Hospital, Melbourne, and Department of Rheumatology, Royal Victorian Eye and Ear Hospital, East Melbourne, and Department of Medical Education, The University of Melbourne, Parkville, Australia.
⁵ L.A. Bradbury, MSc, Department of Rheumatology, Gold Coast University Hospital, Southport, Australia.
⁶ A.M. Briggs, PhD, Curtin School of Allied Health, Curtin University, Perth, Australia.
⁷ A. Brown, PhD, University of South Australia, Clinical and Health Sciences, and Rosemary Bryant AO Research Centre, Adelaide, Australia.
⁸ C. Brown, MPH, J. Cheers, BFA(Hons), L. Hardy, GradCert Health Policy, Arthritis Australia, Sydney, Australia.
⁹ R. Buchbinder, PhD, Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹⁰ L. Carroll, MPhil, Wesley Hospital, Auchenflower, Australia.
¹¹ R. Grainger, PhD, Department of Medicine, University of Otago Wellington, and Wellington Regional Rheumatology Unit, Hutt Hospital, Te Whatu Ora Health New Zealand Capital Coast and Hutt Valley, Wellington, New Zealand.
¹² P. Habib, MBBS, BJC Health, Bondi Junction & Chatswood, Sydney, Australia.
¹³ J.J. Holland, PhD, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia.
¹⁴ T. Hollins, MClinPsych, Pain Management Department, Prince of Wales Hospital, Randwick, Australia.
¹⁵ R. James, MBBS, Faculty of Medicine, University of Queensland Medical School, and Department of Paediatric Rheumatology, Queensland Children's Hospital, Brisbane, Australia.
¹⁶ D. Knapp, M Health Sci Ed, Occupational Therapy, Royal North Shore Hospital, Sydney, Australia.
¹⁷ D.F.L. Liew, MBBS, Department of Rheumatology and Department of Clinical Pharmacology and Therapeutics, Austin Health, and Department of Medicine, The University of Melbourne, Melbourne, Australia.
¹⁸ L. March, PhD, Kolling Institute and Sydney Musculoskeletal Health, University of Sydney, and Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia.
¹⁹ D. Martens, MBBS, Rheumatology Department, Liverpool Hospital, and South West Sydney Clinical Campuses, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
²⁰ C. McCrum, DPT, Rheumatology Department, Canberra Health Service, Canberra, Australia, and Research Centre for Health Professions, University of Brighton, Eastbourne, UK.
²¹ D.R. Neuen, MBBS, Institute for Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Camperdown, Australia.
²² J. Ong, MBBS, Park Ridge Family Practice, Park Ridge, and Wellers Hill Medical Centre, Wellers Hill, Australia.
²³ S.M. Proudman, MBBS(Hons), Discipline of Medicine, Adelaide Medical School, University of Adelaide, and Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia.
²⁴ D. Rowett, PhD, Clinical and Health Sciences, University of South Australia, and Drug and Therapeutics Information Service (DATIS), Southern Adelaide Local Health Network, Adelaide, Australia.
²⁵ S. Schot, BNurs, Rheumatology Unit, Cairns Hospital, Cairns, Australia.
²⁶ M.L. Squance, PhD, School of Medicine and Public Health, The University of Newcastle, and Hunter Medical Research Institute, and MyAutoimmune, Newcastle, Australia.
²⁷ D.E. Turner, PhD, School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
²⁸ S.L. Whittle, MBBS(Hons), Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, and Wellers Hill Medical Centre, Wellers Hill, Queensland, and School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
²⁹ S.A. Wright, Dip Comm Services (Child Care), Young Women's Arthritis Support Group Australia, and Arthritis Australia, Sydney, Australia.
³⁰ H. Keen, PhD, Medical School, University of Western Australia, and Rheumatology Department, South Metropolitan Health Service, Perth, Australia.
³¹ C.L. Hill, MD, Discipline of Medicine, Adelaide Medical School, University of Adelaide, Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia. catherine.hill@sa.gov.au.

PMID: 40451268
DOI: 10.3899/jrheum.2024-1034

Free article

Development of the Australian Rheumatology Association Clinical Care Standard for the Diagnosis and Management of Rheumatoid Arthritis in Adults

Maria B Sukkar et al. J Rheumatol. 2025.

Free article

. 2025 Sep 1;52(9):883-892.

doi: 10.3899/jrheum.2024-1034.

Authors

Affiliations

¹ M.B. Sukkar, PhD, T. Rudd, B.Pharm, Australian Rheumatology Association, Sydney, Australia.
² R. Ainley, Dip. Bus. Admin., CreakyJoints Australia, and Global Healthy Living Foundation Australia, Chatswood, and Young Women's Arthritis Support Group Australia, and Sydney Partnership for Health, Education, Research and Enterprise, Musculoskeletal Health Clinical Academic Group, Consumer Community Council, Sydney, Australia.
³ C. Barrett, MBBS, Faculty of Medicine, University of Queensland Medical School, Brisbane, and Rheumatology Unit, Redcliffe Hospital, Redcliffe, Australia.
⁴ S. Bond, MBBS, Department of Rheumatology, St Vincent's Hospital, Melbourne, and Department of Rheumatology, Royal Victorian Eye and Ear Hospital, East Melbourne, and Department of Medical Education, The University of Melbourne, Parkville, Australia.
⁵ L.A. Bradbury, MSc, Department of Rheumatology, Gold Coast University Hospital, Southport, Australia.
⁶ A.M. Briggs, PhD, Curtin School of Allied Health, Curtin University, Perth, Australia.
⁷ A. Brown, PhD, University of South Australia, Clinical and Health Sciences, and Rosemary Bryant AO Research Centre, Adelaide, Australia.
⁸ C. Brown, MPH, J. Cheers, BFA(Hons), L. Hardy, GradCert Health Policy, Arthritis Australia, Sydney, Australia.
⁹ R. Buchbinder, PhD, Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
¹⁰ L. Carroll, MPhil, Wesley Hospital, Auchenflower, Australia.
¹¹ R. Grainger, PhD, Department of Medicine, University of Otago Wellington, and Wellington Regional Rheumatology Unit, Hutt Hospital, Te Whatu Ora Health New Zealand Capital Coast and Hutt Valley, Wellington, New Zealand.
¹² P. Habib, MBBS, BJC Health, Bondi Junction & Chatswood, Sydney, Australia.
¹³ J.J. Holland, PhD, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia.
¹⁴ T. Hollins, MClinPsych, Pain Management Department, Prince of Wales Hospital, Randwick, Australia.
¹⁵ R. James, MBBS, Faculty of Medicine, University of Queensland Medical School, and Department of Paediatric Rheumatology, Queensland Children's Hospital, Brisbane, Australia.
¹⁶ D. Knapp, M Health Sci Ed, Occupational Therapy, Royal North Shore Hospital, Sydney, Australia.
¹⁷ D.F.L. Liew, MBBS, Department of Rheumatology and Department of Clinical Pharmacology and Therapeutics, Austin Health, and Department of Medicine, The University of Melbourne, Melbourne, Australia.
¹⁸ L. March, PhD, Kolling Institute and Sydney Musculoskeletal Health, University of Sydney, and Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia.
¹⁹ D. Martens, MBBS, Rheumatology Department, Liverpool Hospital, and South West Sydney Clinical Campuses, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
²⁰ C. McCrum, DPT, Rheumatology Department, Canberra Health Service, Canberra, Australia, and Research Centre for Health Professions, University of Brighton, Eastbourne, UK.
²¹ D.R. Neuen, MBBS, Institute for Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Camperdown, Australia.
²² J. Ong, MBBS, Park Ridge Family Practice, Park Ridge, and Wellers Hill Medical Centre, Wellers Hill, Australia.
²³ S.M. Proudman, MBBS(Hons), Discipline of Medicine, Adelaide Medical School, University of Adelaide, and Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia.
²⁴ D. Rowett, PhD, Clinical and Health Sciences, University of South Australia, and Drug and Therapeutics Information Service (DATIS), Southern Adelaide Local Health Network, Adelaide, Australia.
²⁵ S. Schot, BNurs, Rheumatology Unit, Cairns Hospital, Cairns, Australia.
²⁶ M.L. Squance, PhD, School of Medicine and Public Health, The University of Newcastle, and Hunter Medical Research Institute, and MyAutoimmune, Newcastle, Australia.
²⁷ D.E. Turner, PhD, School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
²⁸ S.L. Whittle, MBBS(Hons), Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, and Wellers Hill Medical Centre, Wellers Hill, Queensland, and School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
²⁹ S.A. Wright, Dip Comm Services (Child Care), Young Women's Arthritis Support Group Australia, and Arthritis Australia, Sydney, Australia.
³⁰ H. Keen, PhD, Medical School, University of Western Australia, and Rheumatology Department, South Metropolitan Health Service, Perth, Australia.
³¹ C.L. Hill, MD, Discipline of Medicine, Adelaide Medical School, University of Adelaide, Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia. catherine.hill@sa.gov.au.

PMID: 40451268
DOI: 10.3899/jrheum.2024-1034

Abstract

Objective: To develop a quality standard, termed a Clinical Care Standard (CCS), for the diagnosis and management of rheumatoid arthritis (RA).

Methods: A Working Group with consumer representation cocreated guiding principles and quality statements for RA care through a series of workshops. The process was informed by consumer recommendations, clinical practice guidelines, and international quality criteria. A national survey of healthcare professionals (HCPs) and consumers was conducted to establish consensus. For each quality statement, respondents were asked to indicate, on a scale of 1-9, (1) if it is a priority area for improvement in RA care, and (2) their agreement with the content of the statement. For (1) and (2), respectively, scores between 1 and 4 indicated it was not a priority and disagreement; 5 and 6 indicated it was important but not critical and moderate agreement; and 7 to 9 indicated it was high priority and agreement. Criteria for inclusion were a mean score ≥ 7 for priority and a mean score ≥ 7 for content.

Results: The Working Group formulated 13 quality statements and established 7 guiding principles for RA care. The survey was completed by 605 consumers and 308 HCPs. The predefined criteria for inclusion were met by 12/13 quality statements.

Conclusion: The Australian Rheumatology Association has developed the first CCS for RA in Australia. This standard will serve as an important lever for HCPs and services, consumer organizations, and policy makers to improve the quality of care for adults with RA.

Keywords: healthcare quality indicators; quality of health care; rheumatoid arthritis; standard of care.

Plain language summary

Plain Language SummaryThe Australian Rheumatology Association has developed the first quality standard—termed a Clinical Care Standard—to improve care for people with rheumatoid arthritis (RA). It was developed by a Working Group that included both healthcare professionals and people living with RA.The group developed 13 statements describing key areas for high-quality RA care and identified 7 core principles to guide how care should be delivered. These were based on clinical guidelines, international quality standards, and input from people with RA. To test the importance of each statement, a national survey was conducted. It included 605 people living with RA or their carers, and 308 healthcare professionals from around the country. Participants rated each statement on whether it was a priority for improving RA care and whether they agreed with the statement’s content. Ratings were on a scale from 1 to 9. Only statements that scored an average of 7 or higher in both areas were included.In the end, 12 of the 13 draft statements met the criteria and were included in the final Standard. These statements reflect key areas where improvements in RA care are needed.The new RA Clinical Care Standard will help guide doctors, health services, patient groups, and policy makers to deliver high-quality care for all adults living with RA in Australia.

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Development of the Australian Rheumatology Association Clinical Care Standard for the Diagnosis and Management of Rheumatoid Arthritis in Adults

Affiliations

Development of the Australian Rheumatology Association Clinical Care Standard for the Diagnosis and Management of Rheumatoid Arthritis in Adults

Authors

Affiliations

Abstract

Plain language summary

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous