![]() Most of these combine swollen and tender joint counts, physician and patient global assessments and sometimes laboratory values. Instead of targeting a laboratory test or blood pressure measurement, the “target” in RA is disease activity, which can be measured using a variety of validated tools. Recently, this “treat-to-target” approach has been applied to rheumatoid arthritis (RA). Implementation of disease activity measurement in a typical academic rheumatology clinic can be achieved by standardizing workflow using a simple paper form.Ĭurrent management of many chronic diseases, such as diabetes, hyperlipidemia and hypertension employ treatment strategies to achieve a specific quantitative clinical measure. The second PDSA cycle showed a sustained and dramatic improvement, with 85 % of patients having a disease activity measure recorded over a 27-week period. The first PDSA cycle improved the number of RA patients with documented disease activity measures from 24 % over a 4-week period, to an average of 44 % over an 8-week period. PDSA cycle 2 included the creation of separate patient and physician forms for collection of information, identification of patients prior to their clinic visit and incorporation of medical assistants into the workflow. In PDSA cycle 1, we implemented a paper-based form to help providers assess disease activity in RA patients. Plan-Do-Study-Act (PDSA) methodology was used over two cycles with a goal of increasing provider measurement of disease activity during all RA patient visits. ![]() Recommendations published in 2012 detailed the preferred disease activity measures but there have been few publications on implementation of disease activity measures in a real-world clinic setting. ![]() Treat-to-target is the recommended strategy for the management of rheumatoid arthritis (RA) and involves regular assessment of disease activity using validated measures and subsequent adjustment of medical therapy if patients are not in remission or low disease activity. ![]()
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