Treat-to-target concept implementation for evaluating rheumatoid arthritis patients in daily practice

Abstract

Objective: We aimed to assess the implementation of the treat-to-target (T2T) concept in rheumatoid arthritis (RA) patients in daily practice.Methods: All RA patients visiting one of the 7 academic medical centers in Israel in June 2015 withat least 3 previous clinic visits were included in this study. A common questionnaire was used tocollect data from patients’ medical records, and two independent rheumatologists evaluated thecollected data for the implementation of the T2T concept. The associations between T2T implementation and the categorical and continuous variables were assessed.Results: The study included 724 patients with a mean (standard deviation) age of 62.6 (13.97) yearsand 575 (80.4%) of them were women. Four centers used more than one scoring method, withDisease Activity Score-28 and Clinical Disease Activity Index) being most commonly used. Only276 (38.1%) patients had disease score results in ≥3 visits, and the T2T recommendations were implemented for 245 (33.8%) of the 724 patients. The rate of implementation was higher in younger(p=0.028) rheumatoid factor-positive patients (p=0.011) and varied between centers (11.1%-87%p