INTRODUCTION
Twenty-first-century treatments may be behind a drop in hospital and doctor visits for people with rheumatoid arthritis, according to a study in Sweden.
WHAT DO WE KNOW ALREADY?
In the first part of this century, a number of medicines have made a big difference to people living with the symptoms of rheumatoid arthritis, such as pain, stiffness, and swelling in the joints.
Most people with rheumatoid arthritis who take disease-modifying anti-rheumatic drugs (DMARDs for short) take methotrexate. But for people who find it doesn’t suit them, there are various other options, including the so-called “biologic” DMARDs.
Doctors think that if people start taking these types of drugs very soon after they find out they need treatment, and if they are treated carefully using the right dose, it can result in big improvements in symptoms.
This, in turn, might reduce the number of appointments people need, either at hospital or with a doctor or nurse, and help more people to work and do other everyday things. To find out more, researchers looked at information on about 4,000 people with rheumatoid arthritis in one region in southern Sweden. They looked
at how many people needed to visit a doctor or go to hospital between 2001 and 2010, to see if there was any
change.
WHAT DOES THE NEW STUDY SAY?
In 2010, visits to hospital for rheumatoid arthritis treatment were lower than in 2001 by more than a quarter. Over the same period, the number of times people needed to see a doctor, a nurse, or a physiotherapist, either at their local GP practice or a specialist appointment, fell from around nine times a year to less than
eight for men, and from around 10 times a year to around nine for women.
HOW RELIABLE ARE THE FINDINGS?
The Swedish healthcare register aims to record all of the information about illnesses people have and the prescribed
treatments and operations they have for an illness. The researchers say they had information on about 80 in every 100 people in the region with rheumatoid arthritis. So in this sense, the information is reasonably complete. But the researchers didn’t compare the information about people’s appointments with the records of
which drugs they took. So although they suggest the fall in appointments is linked with better medical treatments, we can’t say for sure that this is the case. It’s possible the reduction was caused by other factors, such as improvements in the standard of care, or that treating more people at home or with other types of treatments
played a role.
WHAT DOES THIS MEAN FOR ME?
This study suggests that, over recent years, there have been improvements in the way that rheumatoid arthritis is treated, although we can’t be sure what form those improvements have taken. But it does offer a reason to be hopeful that, if you have rheumatoid arthritis, it’s likely that you will be better able to manage your symptoms and be less likely to need to see a doctor as time goes on. These findings support other studies suggesting modern treatment strategies are linked to less time off work, better health and less need for surgery.
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Date summary prepared: July 2013
Summary based on research article published on: 8 December 2012
From: Hagel, S. et al. Trends in the first decade of 21st century healthcare utilisation in a rheumatoid arthritis cohort compared with the general population. Ann Rheum Dis 2013;72:1212-1216 doi:10.1136/annrheumdis-2012-202571
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