Immunotherapy Weekly

Data on arthritis discussed by C.R. Kitamura and colleagues

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"A standardized form was used to verify whether the following items were collected at each visit: (1) degree of joint pain, (2) duration of morning stiffness, (3) degree of fatigue, (4) number of tender/swollen joints, and (5) assessment of function. Items recommended for periodic assessment were also collected and included: (1) examination for joint damage, (2) erythrocyte sedimentation rate and/or C-reactive protein, and (3) radiographic assessment of joint damage (radiograph/magnetic resonance imaging). One hundred thirty charts and 313 total visits met inclusion criteria. No rheumatologist consistently assessed each ACR item. Of the recommended items, tender and swollen joint counts and pain were most commonly assessed (95%, 95%, and 69%, respectively). Functional assessment, morning stiffness, and fatigue were least commonly reported (48%, 46%, and 33%, respectively). Items recommended for periodic assessment were not regularly recorded. There was a trend for the recommended items to be reported more regularly for new patients, patients taking a disease modifying antirheumatic drug (DMARD), and patients for whom a DMARD was added or increased in dosage. Rheumatologists follow many but not all of the recommendations included in the revised ACR guidelines. The reasons underlying the noncompliance to some of the recommendations are not fully understood," wrote C.R. Kitamura and colleagues.

The researchers concluded: "In order to improve the adoption of future clinical practice guidelines, the ACR may have to plan specific dissemination and implementation strategies and fund studies to formally assess the effect of guideline use on clinical outcomes."

Kitamura and colleagues published their study in the Journal of Rheumatology (Are the 2002 American College of Rheumatology guidelines for the management of rheumatoid arthritis being followed in Canada's largest academic rheumatology center? Journal of Rheumatology, 2007;34(11):2183-2192).

For additional information, contact S. Carette, Toronto Western Hospital, University of Health Network, 399 Bathurst St., EWI-422, Toronto, ON M5T 2S8, Canada.

Publisher contact information for the Journal of Rheumatology is: J Rheumatol Publ Co., 920 Yonge St., Suite 115, Toronto, Ontario M4W 3C7, Canada.

Keywords: Canada, Toronto, Arthritis, Biotechnology, C Reactive Protein, Fatigue, Immunology, Joint Pain, Magnetic Resonance, Orthopedics, Proteomics, Rheumatoid Arthritis, Rheumatology.

This article was prepared by Immunotherapy Weekly editors from staff and other reports. Copyright 2008, Immunotherapy Weekly via NewsRx.com.