Remit: the diagnosis of early RA, its pharmacological treatment and the role of the multidisciplinary team in improving care of the RA patient.

Aspects covered:

Diagnosis of early rheumatoid arthritis (early diagnosis is a prerequisite for early treatment and is not always easy to achieve)

• Clinical features
  • Assessing a patient
  • Differential diagnosis
• Investigations
• Prognostic features

Principles of treatment (treatment slows disease progression and should be initiated as early as possible))

• Early initiation of treatment
• Patient education
• Assessment of response to treatment
  • Clinical measures
  • Laboratory measures

Pharmacological management (drug therapy, optimum monitoring of efficacy and toxicity, prompt identification of complications of RA and its treatments)

• Analgesics
• Nonsteroidal anti-inflammatory drugs
  • Adverse effects
  • Gastrointestinal toxicity
  • Renal toxicity
  • Disease modifying anti-rheumatic drugs
• Evaluation
  • Timing
  • Sustained therapy
  • Late harm
  • Comparison
  • Efficacy
  • Toxicity
  • Combination therapy
• Targeted immunotherapy
• Intra-articular corticosteroids
• Systematic corticosteroids
  • Oral
  • Parenteral
• Complementary medicine

Role of the multidisciplinary team (a shared care approach ensures optimum treatment of all aspects of the disease)

• Occupational therapy
• Physiotherapy
• Splinting
• Podiatry
• Dietetics

Annexes include

• Health assessment questionnaire
• Key messages for patients
• Patient information

Recommended distribution - target professional groups:

• Consultant physicians, particularly consultant rheumatologists
• General practitioners
• Rheumatology nurse specialists
• Physiotherapists
• Occupational therapists
• Pharmacists
• Dietitians
• Podiatrists
• Junior doctors on medical rotations

Related documents

• Guideline introduction