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National Collaborating Centre for Chronic Conditions (UK). Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults. London: Royal College of Physicians (UK); 2009 Feb. (NICE Clinical Guidelines, No. 79.)

Cover of Rheumatoid Arthritis

Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults.

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11Areas for future research

How cost effective are MRI and ultrasound in establishing the diagnosis and prognosis of small joint synovitis?

How cost effective is the use of anti-CCP in establishing the diagnosis and prognosis of early inflammatory arthritis?

Further evaluations, including cost-effectiveness studies, should take place of the following in people with rheumatoid arthritis:

  • Disease-related written information in recent-onset disease
  • Written self-management materials in recent-onset and established disease
  • Structured 1:1 information giving in recent-onset and established disease
  • Refresher courses and updates
  • Long-term benefits of group behavioural programmes
  • The Arthritis Self Management Programme and the Chronic Disease Self Management Programme in recent-onset and established disease with study populations recruited from out-patient clinics.

The following further evaluations, including cost-effectiveness studies, should take place of in people with rheumatoid arthritis:

  • For exercise, the best methods of delivery, the optimal mode and level of activity, and methods of maximising long-term concordance
  • The individual components of comprehensive physiotherapy, with particular reference to the effectiveness of electrophysical agents, and their optimal timing throughout the course of the disease.

The following further evaluations, including cost-effectiveness studies, should take place in people with rheumatoid arthritis:

  • Comprehensive occupational therapy interventions
  • The usefulness of work rehabilitation programmes, both for those currently in work but at risk of job loss and for those already unemployed but needing help in returning to work.

The role of DMARDs in the treatment of mild rheumatoid arthritis should be assessed.

The cost effectiveness of early management with biological drugs (prior to the failure of two conventional DMARDs) should be assessed.

What is the effect of symptom duration on patient outcomes?

What is the most appropriate treatment strategy when the first anti-TNF-α inhibitor fails?

The components of the nurse specialist’s role that exert the greatest benefits on outcomes in recent-onset and established RA should be investigated.

Copyright © 2009, Royal College of Physicians of London.

All rights reserved. No part of this publication may be reproduced in any form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher.

Bookshelf ID: NBK51800

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