Guideline adherence parameters
| Guideline adherence parameter | Level of measurement |
|---|---|
| Radiographs of hands, feet and thorax ordered within the first 3 visits, in patients with a disease duration ≤1 year | Patients |
| Prescription of conventional and biological DMARDs in agreement with the local preferential sequence | Patients |
| Referral to a specialised nurse within the first 3 visits | Patients |
| Referral to a PA or NP within the first year of treatment | Patients |
| Therapy change* in case of moderate-to-high disease activity† | Visits |
| Regular outpatient clinic visits combined with a nurse-led DAS28 assessment | Visits |
| Correct intervals between regular outpatient clinic visits | Visits |
*Therapy change included the intensification of DMARD therapy (dosage increase, shortening of the interval, adding a new DMARD and/or biological, switching to another DMARD and/or biological), starting or increasing corticosteroids (dose), local corticosteroid injections.
†DAS28>3.2 or corresponding judgement from the rheumatologist if a DAS28 was not available.
DAS28, Disease Activity Score in 28 joints; DMARD, disease modifying anti-rheumatic drug; NP, nurse practitioner; PA, physician assistant.