The Journal of Rheumatology has published a nationwide survey of US rheumatologists and shown that despite trends for increasing metric assessments, nearly half of rheumatoid arthritis (RA) patients are not routinely assessed with a disease activity metric and the evidence they use these in a treat-to-target (T2T) practice is lacking.
Curtis et al set out to assess real-world practices amongst US Rheumatologists regarding quantitative measurements in the care of RA.
They found that 58% of rheumatologists use some quantitative RA measurement tool at most visits. The HAQ and RAPID3 were most commonly used, followed by the CDAI, and use of all measures increased over the 10-year period covered by the 3 surveys.
They surveyed 1918 US Rheumatologists and had 439 respondents (13.8% response who answered 26 questions regarding practice habits and compared responses to similar surveys done in 2005 and 2008.)
Those who measured (metric rheumatologists=58%) were more likely to be in group practice and to use tumor necrosis factor inhibitors. Metric used increased from 2005 to 2014.
The most commonly employed metrics in 2014 included the HAQ (35.5%), RAPID3 (27.1%), CDAI (17.5%), and DAS28 (15.7%). The VECTRA MBDA is used by 12.8% of US Rheumatologists.
Reasons for not measuring included time needed and electronic availability.
Despite evidence that T2T improves outcomes, the use of quantitative measures in RA care is selective and not widespread.
Jack Cush, MD, is the director of clinical rheumatology at the Baylor Research Institute and a professor of medicine and rheumatology at Baylor University Medical Center in Dallas. He is the executive editor of RheumNow.com. A version of this article first appeared on RheumNow, a news, information, and commentary site dedicated to the field of rheumatology. Register to receive their free rheumatology newsletter.
Jack Cush, MD, has no conflicts of interest to disclose.