title: MDHAQ/RAPID3 can provide a roadmap or agenda for all rheumatology visits when the entire MDHAQ is completed at all patient visits and reviewed by the doctor before the encounter.
abstract: The management of rheumatoid arthritis (RA) depends more on the patient history than most other chronic diseases. A patient questionnaire provides a uniform, quantitative, protocolized, "scientific" patient history, with documented prognostic significance for work disability and mortality in RA greater than radiographs and laboratory tests and capacity to distinguish active from control treatment in clinical trials and to monitor clinical care with equivalent or greater significance than joint counts or laboratory tests. Therefore, a "scientific" approach to care of a person with a rheumatic disease involves review of patient function, pain, global status, fatigue, RAPID3, review of systems, self-report joint count, and recent medical history on an MDHAQ before conversation with the patient. This practice may be viewed as analogous to a doctor reviewing blood pressure, hemoglobin A1c, viral load, or radiograph before meeting with a patient who has hypertension, diabetes, HIV, or a healing fracture to provide a roadmap or agenda for the visit. Some sites have implemented RAPID3 without the remainder of MDHAQ, a practice that is discouraged. The MDHAQ requires only 5 to 10 minutes of the patient's time and involves a single sheet of paper, which is needed for a simple RAPID3, or even a patient global estimate of status to score a DAS28 or CDAI. Completion of MDHAQ/RAPID3 by each patient at each visit in the infrastructure of care  with review by the doctor helps prepare the patient for the visit, improves doctor-patient communication, saves time for the doctor, and provides a roadmap or agenda for the visit.
authors.affiliation: Division of Rheumatology, NYU Hospital for Joint Diseases, 301 East 17th Street, Room 1608, New York, New York 10003, USA. tedpincus@gmail.com
authors.forename: Theodore
authors.initials: T
authors.lastname: Pincus
authors.forename: Philip T
authors.initials: PT
authors.lastname: Skummer
authors.forename: Michael T
authors.initials: MT
authors.lastname: Grisanti
authors.forename: Isabel
authors.initials: I
authors.lastname: Castrejón
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yazici
mesh_terms: D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D011379:Prognosis; D012017:Referral and Consultation; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D012219:Rheumatology / Q000379:methods*; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D057188:Workflow