OBJECTIVE: To assess agreement and application of Treat to Target (T2T) recommendations in Canadian practice. METHODS: A survey of Canadian rheumatologists was conducted on the recommendations of T2T, an international initiative toward reaching specific therapeutic goals in rheumatoid arthritis. Agreement with each recommendation was measured on a 10-point Likert scale (1 = fully disagree, 10 = fully agree). A 4-point Likert scale (never, not very often, very often, always) assessed application of each recommendation in current practice. Responders who answered "never" or "not very often" were asked whether they were willing to change their practice according to the particular recommendation. RESULTS: Seventy-eight rheumatologists responded (24% of the 330 who were contacted). The average agreement scores ranged from 6.92 for recommendation #5 (the frequency of measures of disease activity) to 9.10 for recommendation #10 (the patient needs to be involved in the decision-making process). A majority of participants indicated that they apply the T2T recommendations in their practice. Recommendations dealing with frequency of visits and the use of composite measures received the highest number of "never" or "not very often" responses. Busy practices and lack of confidence in composite outcome measures were the main reasons for objections to certain components of the recommendations. CONCLUSION: Although a majority of Canadian rheumatologists agreed with and supported the T2T recommendations, there was resistance toward specific aspects of these recommendations. Efforts are needed to better understand the reasons behind identified disagreements. Action plans to encourage the application of T2T recommendations in Canada are in development.
OBJECTIVE: To assess agreement and application of Treat to Target (T2T) recommendations in Canadian practice. METHODS: A survey of Canadian rheumatologists was conducted on the recommendations of T2T, an international initiative toward reaching specific therapeutic goals in rheumatoid arthritis. Agreement with each recommendation was measured on a 10-point Likert scale (1 = fully disagree, 10 = fully agree). A 4-point Likert scale (never, not very often, very often, always) assessed application of each recommendation in current practice. Responders who answered "never" or "not very often" were asked whether they were willing to change their practice according to the particular recommendation. RESULTS: Seventy-eight rheumatologists responded (24% of the 330 who were contacted). The average agreement scores ranged from 6.92 for recommendation #5 (the frequency of measures of disease activity) to 9.10 for recommendation #10 (the patient needs to be involved in the decision-making process). A majority of participants indicated that they apply the T2T recommendations in their practice. Recommendations dealing with frequency of visits and the use of composite measures received the highest number of "never" or "not very often" responses. Busy practices and lack of confidence in composite outcome measures were the main reasons for objections to certain components of the recommendations. CONCLUSION: Although a majority of Canadian rheumatologists agreed with and supported the T2T recommendations, there was resistance toward specific aspects of these recommendations. Efforts are needed to better understand the reasons behind identified disagreements. Action plans to encourage the application of T2T recommendations in Canada are in development.
Authors: Emilia Gvozdenović; Cornelia F Allaart; Désirée van der Heijde; Gianfranco Ferraccioli; Josef S Smolen; Tom W J Huizinga; Robert Landewé Journal: RMD Open Date: 2016-04-28
Authors: Josef S Smolen; Monika Schöls; Jürgen Braun; Maxime Dougados; Oliver FitzGerald; Dafna D Gladman; Arthur Kavanaugh; Robert Landewé; Philip Mease; Joachim Sieper; Tanja Stamm; Maarten de Wit; Daniel Aletaha; Xenofon Baraliakos; Neil Betteridge; Filip van den Bosch; Laura C Coates; Paul Emery; Lianne S Gensler; Laure Gossec; Philip Helliwell; Merryn Jongkees; Tore K Kvien; Robert D Inman; Iain B McInnes; Mara Maccarone; Pedro M Machado; Anna Molto; Alexis Ogdie; Denis Poddubnyy; Christopher Ritchlin; Martin Rudwaleit; Adrian Tanew; Bing Thio; Douglas Veale; Kurt de Vlam; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2017-07-06 Impact factor: 19.103
Authors: Peter C Taylor; Rieke Alten; Juan J Gomez Reino; Roberto Caporali; Philippe Bertin; Emma Sullivan; Robert Wood; James Piercy; Radu Vasilescu; Dean Spurden; Jose Alvir; Miriam Tarallo Journal: Patient Prefer Adherence Date: 2018-10-04 Impact factor: 2.711
Authors: Emilia Gvozdenović; Ron Wolterbeek; Désirée van der Heijde; Tom Huizinga; Cornelia Allaart; Robert Landewé Journal: BMC Musculoskelet Disord Date: 2016-01-16 Impact factor: 2.362