Were the patterns of treatment for rheumatoid arthritis during 1977-1992 consistent with modern clinical guidelines?
OBJECTIVE
Quality assessment of the long-term treatment of patients with rheumatoid arthritis (RA).


METHODS
Treatment patterns in a cohort of 70 local and 77 distant RA patients during 1977-1992 were reviewed retrospectively and compared to modern clinical guidelines.


RESULTS
In 1977 disease-modifying anti-rheumatic drugs (DMARDs) were given to 62% of the new, hospitalised patients, systemic corticosteroids to 7%, and corticosteroid joint injections to 24%. Patients with short disease duration and/or serious disease were selected for DMARD-treatment. Rheumasurgery was performed on 21%. During follow-up of local patients 54% were recorded with DMARDs for a mean duration of 29 months; approximately 1/5 of the follow-up period. Methotrexate was used infrequently. Local and systemic corticosteroids were recorded in approximately 20%. Rheumasurgery, predominantly non-prosthetic, was performed on 27%.


CONCLUSIONS
Patients with early and serious disease were selected for DMARD-therapy, but the treatment duration was too short for modern requirements. Pharmaceutical and surgical treatment patterns were otherwise mainly consistent with present guidelines.
Kvalvik
A G
AG
Haugesund Rheumatism Hospital, Norway.
Aadland
H A
HA
Høyeraal
H M
HM
Larsen
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D001178:Arthroplasty; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents