A COMPARISON OF DISEASE STATUS IN RHEUMATOID-ARTHRITIS PATIENTS ATTENDING AND NOT ATTENDING A SPECIALIST CLINIC

The objective was to test the hypothesis that rheumatoid arthritis (RA ) patients currently not receiving specialist care have milder and les s active disease than clinic attenders. The subjects were recruited fr om a media campaign aimed at identifying RA patients for a nationwide twin study. All subjects were interviewed at home and examined. Data f rom serological and radiological investigations were obtained. Data we re also obtained about any specialist care, including the dale, where relevant, of the most recent hospital appointment. For subjects report ing ever attending a specialist clinic, the current status (discharged /under current care) and the date of their most recent appointment wer e verified from hospital records. Data from 149 patients were analysed , of whom 114 (76%) were current hospital clinic attenders at the time of interview, 10 (7%) had never attended and 25 (17%) were ex-attende rs. There was a similar proportion with current morning stiffness (>1 h) in al three groups (60%). The median number of (i) swollen (S) join ts, (ii) tender (T) joints and (iii) swollen and tender (ST) joints wa s almost identical-current attenders: (S) 7, (T) 9, (ST) 11; ex-attend ers: (S) 5, (T) 8, (ST) 10; never attenders: (S) 7, (T) 14, (ST) 17. T here were similar proportions with radiological erosions in the curren t and ex-attenders (79 and 72%, respectively). Current attenders were, however, substantially more likely to be taking disease-modifying dru gs. In these volunteer patients, those currently managed entirely in p rimary care did not have less severe or active disease.