Rheumatoid arthritis: NICE issues an updated quality standard


  • Pavankumar Kamat
  • UK Medical News
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The National Institute for Health and Care Excellence (NICE) has issued an updated quality standard focusing on the assessment, diagnosis and management of rheumatoid arthritis in individuals aged >16 years, with respect to high-quality care in priority areas for improvement.

The key goals of the quality standard are improvements in the following areas:

  • disease control;
  • health-related quality of life;
  • employment;
  • patients' satisfaction with support to manage their condition; and
  • patients' experience of GP and outpatient services.

The quality standard covers the following five recommendations:

  1. Individuals with suspected persistent synovitis affecting more than one joint, or the small joints of the hands and feet, should be referred to rheumatology services within three working days of primary care presentation.
  2. Conventional disease-modifying anti-rheumatic drug monotherapy should be initiated within six weeks of referral in individuals with rheumatoid arthritis, and their clinical progress should be monitored monthly until their treatment target is achieved.
  3. Individuals with rheumatoid arthritis should be provided with opportunities during the course of their disease to participate in educational activities that support self-management.
  4. Individuals with rheumatoid arthritis experiencing disease flares or potential treatment-related side effects should receive advice within one working day of contacting rheumatology services.
  5. Individuals with rheumatoid arthritis should undergo a comprehensive annual review coordinated by rheumatology services.