title: Use of clinical scores to guide therapeutic decisions in patients with rheumatoid arthritis in daily care.
abstract: OBJECTIVE
  This study focuses on the application and impact of different clinical scores for treatment changes in daily practice in patients with rheumatoid arthritis (RA), as achieving remission is a feasible aim due to considerable improvements in therapeutic options.
  
  
  METHODS
  In this prospective study, 1467 RA patients aged 15 to 88 years (72.5% female, 27.5% male) who had undergone treatment change or were treated with a disease-modifying antirheumatic drug (DMARD) for the first time were analysed. At three consecutive visits (T-1, T0, T1), scores were used to assess disease activity, loss of function, quality of life and imaging. In addition, the impact of the scores on treatment change was addressed (numerical rating scale, 1-10).
  
  
  RESULTS
  The most commonly used scores were the DAS28 (65% of all visits), the Hanover functional ability questionnaire (FFbH, 36%) and the HAQ (11%). Other scores for evaluating RA are of little relevance in daily practice. No scores were calculated in only 10% of visits. Among the commonly used scores, the DAS28 had the highest influence on therapy decisions, followed by HAQ and FFbH (mean weight 6.62, 4.99 and 4.41, respectively).
  
  
  CONCLUSIONS
  In daily practice, rheumatologists very often take scores for disease activity (especially DAS28) and loss of physical function into consideration when deciding on treatment for patients with RA. However, scores for measuring structural changes or quality of life, are not yet very well established with German rheumatologists.
authors.affiliation: University Hospital Leipzig, Department for Gastroenterology and Rheumatology, Rheumatology Unit, Leipzig, Germany.
authors.forename: Olga
authors.initials: O
authors.lastname: Malysheva
authors.affiliation: University Hospital Leipzig, Department for Gastroenterology and Rheumatology, Rheumatology Unit, Leipzig, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Bedrich
authors.affiliation: Rotes Kreuz Hospital Bremen, Department for Internal Rheumatology, Bremen, Germany.
authors.forename: J G
authors.initials: JG
authors.lastname: Kuipers
authors.affiliation: AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Kleine
authors.affiliation: AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Wolff
authors.affiliation: University Hospital Leipzig, Department for Gastroenterology and Rheumatology, Rheumatology Unit, Leipzig, Germany.
authors.forename: Christoph G
authors.initials: CG
authors.lastname: Baerwald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D003661:Decision Support Techniques; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012074:Remission Induction; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents