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Rheumatoid arthritis in adults: management [NG100]

Measuring the use of this guidance

Recommendation: 1.2.1

Treat active RA in adults with the aim of achieving a target of remission or low disease activity if remission cannot be achieved (treat-to-target). [2018]

What was measured: The proportion of people with confirmed early inflammatory arthritis who had a treatment target set and agreed.
Data collection end: May 2019
84%
Number that met the criteria: 5483 / 6952
Area covered: England and Wales
Source: The British Society for Rheumatology. National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.


Recommendation: 1.3.2

Offer verbal and written information to adults with RA to: improve their understanding of the condition and its management, and counter any misconceptions they may have. [2009]

What was measured: Proportion of people with rheumatoid arthritis who were offered educational and self-management activities within 1 month of diagnosis when they returned for follow up.
Data collection end: May 2019
81%
Number that met the criteria: 1057 / 1300
Area covered: England and Wales
Source: The British Society for Rheumatology. National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.

What was measured: The proportion of clinicians who reported that their patients with diagnosed early inflammatory arthritis for at least 3 months have been provided disease-specific education, including information on self management.
Data collection end: May 2019
93%
Number that met the criteria: 6529 / 6993
Area covered: England and Wales
Source: The British Society for Rheumatology. National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.


Recommendation: 1.4.1

For adults with newly diagnosed active RA: Offer first-line treatment with conventional disease-modifying anti-rheumatic drug (cDMARD) monotherapy using oral methotrexate, leflunomide or sulfasalazine as soon as possible and ideally within 3 months of onset of persistent symptoms. Consider hydroxychloroquine for first-line treatment as an alternative to oral methotrexate, leflunomide or sulfasalazine for mild or palindromic disease. Escalate dose as tolerated. [2018]

What was measured: The proportion of people with diagnosed early inflammatory arthritis starting a cDMARD within six weeks of referral.
Data collection end: May 2019
54%
Number that met the criteria: 2360 / 4378
Area covered: England and Wales
Source: The British Society for Rheumatology. National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.


Recommendation: 1.9.3

Offer all adults with RA, including those who have achieved the treatment target, an annual review to: •assess disease activity and damage, and measure functional ability (using, for example, the Health Assessment Questionnaire [HAQ]) •check for the development of comorbidities, such as hypertension, ischaemic heart disease, osteoporosis and depression •assess symptoms that suggest complications, such as vasculitis and disease of the cervical spine, lung or eyes •organise appropriate cross referral within the multidisciplinary team

What was measured: RA002: The percentage of patients with rheumatoid arthritis, on the register, who have had a face-to-face review in the preceding 12 months.
Data collection end: March 2019
84.15%
Area covered: National
Source: Health and Social Care Information Centre. Quality and Outcomes Framework.



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