Treatment perspectives in rheumatoid arthritis: a descriptive study in a Swedish healthcare district

This study analyses patterns of treatment offered to individuals with a clinical diagnosis of rheumatoid arthritis (RA). A cross-sectional investigation was carried out in 321 patients (aged greater than 16 years) fulfilling the 1958 American Rheumatism Association (ARA) criteria for RA. Medical records were scrutinised retrospectively for information about medical, surgical and other treatments during a 5-year period (1982 to 1986). All patients had received medical treatment, but a large number had discontinued drug therapy because of adverse effects or lack of efficacy. 45.9% of the individuals were receiving 1 drug at the time of the survey, 33.8% were on 2 drugs, 11.7% were on 3 or 4 drugs, and 8.6% were not receiving any medication. Nearly 50% of the patients had had various kinds of surgical procedures performed. The clinical manifestation of the disease, as measured by the number of ARA criteria fulfilled, showed a linear correlation to nearly all medical and surgical treatments. A primary healthcare physician was the basic contact person for 90% of the patients, but in addition 70% of the participants had been examined at sometime by a rheumatological specialist. The study confirms our expectations that patients with RA receive numerous pharmaceutical and other treatments. Even patients with mild and/or early disease (probable RA) had received a considerable amount of treatment. Qualified specialised care was also provided despite the distance to a university referral centre.