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Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines
INTRODUCTION: International recommendations are intended to help rheumatologists in the effective management of rheumatoid arthritis (RA) through an evidence-based approach. This research aimed to evaluate management patterns and associated difficulties encountered by rheumatologists in daily practi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425259/ https://www.ncbi.nlm.nih.gov/pubmed/34522257 http://dx.doi.org/10.5114/aoms.2019.84092 |
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author | Batko, Bogdan Korkosz, Mariusz Juś, Anna Wiland, Piotr |
author_facet | Batko, Bogdan Korkosz, Mariusz Juś, Anna Wiland, Piotr |
author_sort | Batko, Bogdan |
collection | PubMed |
description | INTRODUCTION: International recommendations are intended to help rheumatologists in the effective management of rheumatoid arthritis (RA) through an evidence-based approach. This research aimed to evaluate management patterns and associated difficulties encountered by rheumatologists in daily practice. MATERIAL AND METHODS: Interviewers recruited 101 Polish rheumatologists in a random quota-based, nationwide sample of outpatient clinics. Quantitative data were input online using a computer-assisted web interview tool. RESULTS: Disease-modifying antirheumatic drugs (DMARDs) are not initiated at the time of diagnosis in 15% of RA patients, most often due to difficulties in patient-provider communication. The RA activity is assessed every 4 to 6 months by 30% of rheumatologists, and 64% of patients are reported to never achieve remission. Composite indices are the most reliable indicators of remission only for 38% of responders. Despite inadequate disease control with ≥ 2 treatment schedules with synthetic DMARDs, 34% of these patients are not considered for biological DMARDs (bDMARDs). Contraindications and reimbursement barriers are the most frequently stated reasons. Therapy with glucocorticoid (GC) lasting over 3 months is reported by 70% of rheumatologists. International recommendations are stated as the most common basis for treatment decisions. CONCLUSIONS: Awareness of recommendations is not sufficient to ensure their application in clinical practice. Inadequate management of RA is quite prevalent, with a substantial contribution of non-medical factors. Daily practice mainly deviates from guidelines regarding frequency and mode of monitoring measures, time to DMARD initiation, and duration of GC treatment. Education programs and policy changes may significantly narrow the gap between evidence and practice. |
format | Online Article Text |
id | pubmed-8425259 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-84252592021-09-13 Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines Batko, Bogdan Korkosz, Mariusz Juś, Anna Wiland, Piotr Arch Med Sci Clinical Research INTRODUCTION: International recommendations are intended to help rheumatologists in the effective management of rheumatoid arthritis (RA) through an evidence-based approach. This research aimed to evaluate management patterns and associated difficulties encountered by rheumatologists in daily practice. MATERIAL AND METHODS: Interviewers recruited 101 Polish rheumatologists in a random quota-based, nationwide sample of outpatient clinics. Quantitative data were input online using a computer-assisted web interview tool. RESULTS: Disease-modifying antirheumatic drugs (DMARDs) are not initiated at the time of diagnosis in 15% of RA patients, most often due to difficulties in patient-provider communication. The RA activity is assessed every 4 to 6 months by 30% of rheumatologists, and 64% of patients are reported to never achieve remission. Composite indices are the most reliable indicators of remission only for 38% of responders. Despite inadequate disease control with ≥ 2 treatment schedules with synthetic DMARDs, 34% of these patients are not considered for biological DMARDs (bDMARDs). Contraindications and reimbursement barriers are the most frequently stated reasons. Therapy with glucocorticoid (GC) lasting over 3 months is reported by 70% of rheumatologists. International recommendations are stated as the most common basis for treatment decisions. CONCLUSIONS: Awareness of recommendations is not sufficient to ensure their application in clinical practice. Inadequate management of RA is quite prevalent, with a substantial contribution of non-medical factors. Daily practice mainly deviates from guidelines regarding frequency and mode of monitoring measures, time to DMARD initiation, and duration of GC treatment. Education programs and policy changes may significantly narrow the gap between evidence and practice. Termedia Publishing House 2019-03-29 /pmc/articles/PMC8425259/ /pubmed/34522257 http://dx.doi.org/10.5114/aoms.2019.84092 Text en Copyright: © 2019 Termedia & Banach https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Clinical Research Batko, Bogdan Korkosz, Mariusz Juś, Anna Wiland, Piotr Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines |
title | Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines |
title_full | Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines |
title_fullStr | Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines |
title_full_unstemmed | Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines |
title_short | Management of rheumatoid arthritis in Poland – where daily practice might not always meet evidence-based guidelines |
title_sort | management of rheumatoid arthritis in poland – where daily practice might not always meet evidence-based guidelines |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425259/ https://www.ncbi.nlm.nih.gov/pubmed/34522257 http://dx.doi.org/10.5114/aoms.2019.84092 |
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