Clinical quality management in rheumatoid arthritis

Clinical quality management in rheumatoid arthritis (RA) aims at reducing i nflammatory activity and pain in the short term and damage and disability i n the long term. In the "Swiss Clinical Quality Management in rheumatoid ar thritis" (SCQM) project, which started in 1997, a measurement-improvement s ystem with feedback reports allows the rheumatologists to follow their RA p atients with the aim of improving the quality of outcome. Inflammatory acti vity is measured with the Disease Activity Score (DAS28) and the Rheumatoid Arthritis Disease Activity Index questionnaire (RADAI), damage with an X-r ay score and disability with the Stanford Health Assessement Questionnaire (HAQ). The feedback is used by the individual rheumatologist to optimize th e therapy of his/her RA patients. Beside the aim of improving the quality of treatment, the SCQM projects wan ts to build a Swiss cohort of RA patients, to improve the collaboration of rheumatologists in the clinic and in practice and to establish standards of treatment in RA. In this paper we describe the SCQM project in detail, we show two cases ill ustrating the usefulness of the SCQM in the management of individual RA pat ients, and we present the cross sectional analysis of the first 1223 RA pat ients included in the project.