The National Institute for Health and Care Excellence (NICE) has issued an updated quality standard which focusses on diagnosis and management of rheumatoid arthritis in individuals aged ≥16 years, with respect to high-quality care in priority areas for improvement. In this update, statements 3 and 5 have been amended.
The quality standard covers the following 7 recommendations:
- Individuals with suspected persistent synovitis of small joints of the hands or feet, or more than one joint, should be referred to a rheumatology service within 3 days of presentation.
- Individuals with suspected persistent synovitis require assessment in a rheumatology service within 3 weeks of referral.
- Individuals with a new diagnosis of rheumatoid arthritis should be offered conventional disease-modifying anti-rheumatic drug monotherapy within 3 months of persistent symptom onset.
- Affected individuals should be provided with educational and self-management activities within 1 month of diagnosis.
- Affected individuals should have their C-reactive protein and disease activity evaluated every month in specialist care until remission or low disease activity is evident.
- Affected individuals with disease flares or potential drug-related side effects should receive advice within 1 working day of contacting the rheumatology service.
- Affected individuals should have a comprehensive annual review coordinated by the rheumatology service.
Health professionals should also take into consideration the quality standard on “Patient experience in adult NHS services” when providing services for heavy rheumatoid arthritis.