Were the patterns of treatment for rheumatoid arthritis during 1977-1992 consistent with modern clinical guidelines?

Objective: Quality assessment of the long-term treatment of patients with r heumatoid arthritis (RA). Methods: Treatment patterns in a cohort of 70 local and 77 distant RA patie nts during 1977 1992 were reviewed retrospectively and compared to modern c linical guidelines. Results: In 1977 disease-modifying anti-rheumatic drugs (DMARDs) were given to 62% of the new, hospitalised patients, systemic corticosteroids to 7%, and corticosteroid joint injections to 24%. Patients with short disease dur ation and/or serious disease were selected for DMARD-treatment. Rheumasurge ry was performed on 21%. During follow-up off local patients 54% were recor ded with DMARDs for a mean duration of 29 months: approximately 1/5 of the follow-up period. Methods tate was used infrequently. Local and systemic co rticosteroids were recorded in approximately 20%. Rheumasurgery, predominan tly non-prosthetic, was performed on 27%. Conclusions: Patients with early and serious disease were selected for DMAR D-therapy, but the treatment duration was too short for modern requirements . Pharmaceutical and surgical treatment patterns were otherwise mainly cons istent with present guidelines.