title: Treating rheumatoid arthritis to target: a Canadian physician survey.
abstract: OBJECTIVE
  To assess agreement and application of Treat to Target (T2T) recommendations in Canadian practice.
  
  
  METHODS
  A survey of Canadian rheumatologists was conducted on the recommendations of T2T, an international initiative toward reaching specific therapeutic goals in rheumatoid arthritis. Agreement with each recommendation was measured on a 10-point Likert scale (1 = fully disagree, 10 = fully agree). A 4-point Likert scale (never, not very often, very often, always) assessed application of each recommendation in current practice. Responders who answered "never" or "not very often" were asked whether they were willing to change their practice according to the particular recommendation.
  
  
  RESULTS
  Seventy-eight rheumatologists responded (24% of the 330 who were contacted). The average agreement scores ranged from 6.92 for recommendation #5 (the frequency of measures of disease activity) to 9.10 for recommendation #10 (the patient needs to be involved in the decision-making process). A majority of participants indicated that they apply the T2T recommendations in their practice. Recommendations dealing with frequency of visits and the use of composite measures received the highest number of "never" or "not very often" responses. Busy practices and lack of confidence in composite outcome measures were the main reasons for objections to certain components of the recommendations.
  
  
  CONCLUSIONS
  Although a majority of Canadian rheumatologists agreed with and supported the T2T recommendations, there was resistance toward specific aspects of these recommendations. Efforts are needed to better understand the reasons behind identified disagreements. Action plans to encourage the application of T2T recommendations in Canada are in development.
authors.affiliation: Université de Montréal, Montréal, Québec, Canada. bharaoui@videotron.ca
authors.forename: Boulos
authors.initials: B
authors.lastname: Haraoui
authors.forename: William
authors.initials: W
authors.lastname: Bensen
authors.forename: Louis
authors.initials: L
authors.lastname: Bessette
authors.forename: Sharon
authors.initials: S
authors.lastname: Le Clercq
authors.forename: Carter
authors.initials: C
authors.lastname: Thorne
authors.forename: John
authors.initials: J
authors.lastname: Wade
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D002170:Canada; D032921:Consensus; D019983:Guideline Adherence; D019538:Health Care Surveys / Q000592:standards / Q000639:trends*; D006801:Humans; D010820:Physicians / Q000523:psychology; D017410:Practice Guidelines as Topic / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards; D012219:Rheumatology / Q000592:standards / Q000639:trends*