Regional and temporal variation in the treatment of rheumatoid arthritis across the UK: a descriptive register-based cohort study. Edwards, C. J., Campbell, J., van Staa, T., & Arden, N. K. BMJ open, 2012. doi abstract bibtex OBJECTIVES: To describe current disease-modifying antirheumatic drugs (DMARDs) prescription in rheumatoid arthritis (RA) with reference to best practice and to identify temporal and regional trends in the UK. DESIGN: Descriptive, register-based cohort study. PARTICIPANTS: Permanently registered patients aged ≥18 years with a recorded diagnosis of RA between 1 January 1995 and 31 March 2010 and matched controls. Participants with RA were identified through screening of all patients in the General Practice Research Database (GPRD) with a clinical or referral record for RA and at least 1 day of follow-up. SETTING: 639 general practices in the UK supplying data to the GPRD. MAIN OUTCOME MEASURES: Medication prescribing between 3 and 12 months of RA diagnosis by region and time period (1995-1999, 2000-2005 and 2006-April 2010). RESULTS: Of the 35 911 patients in the full RA cohort, 15 259 patients (42%) had incident RA. Analysis of prescribing in incident RA patients demonstrated that between 1995 (baseline) and 2010 there was a substantial increase in DMARD, and specifically methotrexate, prescribing across all regions with a less marked increase in combination DMARD prescribing. Taking 12-month prescribing as a snapshot: DMARD prescribing was 19-49% at baseline increasing to 45-74% by 2006-April 2010; methotrexate prescribing was 4-16% at baseline increasing to 32-60%; combination DMARD prescribing was 0-8% at baseline increasing to 3-17%. However, there was marked regional variation in the proportion of RA patients receiving DMARD regardless of time period. CONCLUSIONS: There has been a substantial increase in prescribing of DMARDs for RA since 1995; however, regional variation persists across the UK with relative undertreatment, according to established best practice. Improved implementation of evidence-based best clinical practice to facilitate removal of treatment variation is warranted. This may occur as a result of the implementation of published national guidance.
@article{edwards_regional_2012,
title = {Regional and temporal variation in the treatment of rheumatoid arthritis across the {UK}: a descriptive register-based cohort study},
volume = {2},
issn = {2044-6055},
shorttitle = {Regional and temporal variation in the treatment of rheumatoid arthritis across the {UK}},
doi = {10.1136/bmjopen-2012-001603},
abstract = {OBJECTIVES: To describe current disease-modifying antirheumatic drugs (DMARDs) prescription in rheumatoid arthritis (RA) with reference to best practice and to identify temporal and regional trends in the UK.
DESIGN: Descriptive, register-based cohort study.
PARTICIPANTS: Permanently registered patients aged ≥18 years with a recorded diagnosis of RA between 1 January 1995 and 31 March 2010 and matched controls. Participants with RA were identified through screening of all patients in the General Practice Research Database (GPRD) with a clinical or referral record for RA and at least 1 day of follow-up.
SETTING: 639 general practices in the UK supplying data to the GPRD.
MAIN OUTCOME MEASURES: Medication prescribing between 3 and 12 months of RA diagnosis by region and time period (1995-1999, 2000-2005 and 2006-April 2010).
RESULTS: Of the 35 911 patients in the full RA cohort, 15 259 patients (42\%) had incident RA. Analysis of prescribing in incident RA patients demonstrated that between 1995 (baseline) and 2010 there was a substantial increase in DMARD, and specifically methotrexate, prescribing across all regions with a less marked increase in combination DMARD prescribing. Taking 12-month prescribing as a snapshot: DMARD prescribing was 19-49\% at baseline increasing to 45-74\% by 2006-April 2010; methotrexate prescribing was 4-16\% at baseline increasing to 32-60\%; combination DMARD prescribing was 0-8\% at baseline increasing to 3-17\%. However, there was marked regional variation in the proportion of RA patients receiving DMARD regardless of time period.
CONCLUSIONS: There has been a substantial increase in prescribing of DMARDs for RA since 1995; however, regional variation persists across the UK with relative undertreatment, according to established best practice. Improved implementation of evidence-based best clinical practice to facilitate removal of treatment variation is warranted. This may occur as a result of the implementation of published national guidance.},
language = {eng},
number = {6},
journal = {BMJ open},
author = {Edwards, Christopher John and Campbell, Jennifer and van Staa, Tjeerd and Arden, Nigel K.},
year = {2012},
pmid = {23144258},
pmcid = {PMC3533005}
}
Downloads: 0
{"_id":"NYekwCqd3FRYwKFFy","bibbaseid":"edwards-campbell-vanstaa-arden-regionalandtemporalvariationinthetreatmentofrheumatoidarthritisacrosstheukadescriptiveregisterbasedcohortstudy-2012","downloads":0,"creationDate":"2017-08-15T09:38:10.220Z","title":"Regional and temporal variation in the treatment of rheumatoid arthritis across the UK: a descriptive register-based cohort study","author_short":["Edwards, C. J.","Campbell, J.","van Staa, T.","Arden, N. K."],"year":2012,"bibtype":"article","biburl":"http://bibbase.org/zotero/veegee78","bibdata":{"bibtype":"article","type":"article","title":"Regional and temporal variation in the treatment of rheumatoid arthritis across the UK: a descriptive register-based cohort study","volume":"2","issn":"2044-6055","shorttitle":"Regional and temporal variation in the treatment of rheumatoid arthritis across the UK","doi":"10.1136/bmjopen-2012-001603","abstract":"OBJECTIVES: To describe current disease-modifying antirheumatic drugs (DMARDs) prescription in rheumatoid arthritis (RA) with reference to best practice and to identify temporal and regional trends in the UK. DESIGN: Descriptive, register-based cohort study. PARTICIPANTS: Permanently registered patients aged ≥18 years with a recorded diagnosis of RA between 1 January 1995 and 31 March 2010 and matched controls. Participants with RA were identified through screening of all patients in the General Practice Research Database (GPRD) with a clinical or referral record for RA and at least 1 day of follow-up. SETTING: 639 general practices in the UK supplying data to the GPRD. MAIN OUTCOME MEASURES: Medication prescribing between 3 and 12 months of RA diagnosis by region and time period (1995-1999, 2000-2005 and 2006-April 2010). RESULTS: Of the 35 911 patients in the full RA cohort, 15 259 patients (42%) had incident RA. Analysis of prescribing in incident RA patients demonstrated that between 1995 (baseline) and 2010 there was a substantial increase in DMARD, and specifically methotrexate, prescribing across all regions with a less marked increase in combination DMARD prescribing. Taking 12-month prescribing as a snapshot: DMARD prescribing was 19-49% at baseline increasing to 45-74% by 2006-April 2010; methotrexate prescribing was 4-16% at baseline increasing to 32-60%; combination DMARD prescribing was 0-8% at baseline increasing to 3-17%. However, there was marked regional variation in the proportion of RA patients receiving DMARD regardless of time period. CONCLUSIONS: There has been a substantial increase in prescribing of DMARDs for RA since 1995; however, regional variation persists across the UK with relative undertreatment, according to established best practice. Improved implementation of evidence-based best clinical practice to facilitate removal of treatment variation is warranted. This may occur as a result of the implementation of published national guidance.","language":"eng","number":"6","journal":"BMJ open","author":[{"propositions":[],"lastnames":["Edwards"],"firstnames":["Christopher","John"],"suffixes":[]},{"propositions":[],"lastnames":["Campbell"],"firstnames":["Jennifer"],"suffixes":[]},{"propositions":["van"],"lastnames":["Staa"],"firstnames":["Tjeerd"],"suffixes":[]},{"propositions":[],"lastnames":["Arden"],"firstnames":["Nigel","K."],"suffixes":[]}],"year":"2012","pmid":"23144258","pmcid":"PMC3533005","bibtex":"@article{edwards_regional_2012,\n\ttitle = {Regional and temporal variation in the treatment of rheumatoid arthritis across the {UK}: a descriptive register-based cohort study},\n\tvolume = {2},\n\tissn = {2044-6055},\n\tshorttitle = {Regional and temporal variation in the treatment of rheumatoid arthritis across the {UK}},\n\tdoi = {10.1136/bmjopen-2012-001603},\n\tabstract = {OBJECTIVES: To describe current disease-modifying antirheumatic drugs (DMARDs) prescription in rheumatoid arthritis (RA) with reference to best practice and to identify temporal and regional trends in the UK.\nDESIGN: Descriptive, register-based cohort study.\nPARTICIPANTS: Permanently registered patients aged ≥18 years with a recorded diagnosis of RA between 1 January 1995 and 31 March 2010 and matched controls. Participants with RA were identified through screening of all patients in the General Practice Research Database (GPRD) with a clinical or referral record for RA and at least 1 day of follow-up.\nSETTING: 639 general practices in the UK supplying data to the GPRD.\nMAIN OUTCOME MEASURES: Medication prescribing between 3 and 12 months of RA diagnosis by region and time period (1995-1999, 2000-2005 and 2006-April 2010).\nRESULTS: Of the 35 911 patients in the full RA cohort, 15 259 patients (42\\%) had incident RA. Analysis of prescribing in incident RA patients demonstrated that between 1995 (baseline) and 2010 there was a substantial increase in DMARD, and specifically methotrexate, prescribing across all regions with a less marked increase in combination DMARD prescribing. Taking 12-month prescribing as a snapshot: DMARD prescribing was 19-49\\% at baseline increasing to 45-74\\% by 2006-April 2010; methotrexate prescribing was 4-16\\% at baseline increasing to 32-60\\%; combination DMARD prescribing was 0-8\\% at baseline increasing to 3-17\\%. However, there was marked regional variation in the proportion of RA patients receiving DMARD regardless of time period.\nCONCLUSIONS: There has been a substantial increase in prescribing of DMARDs for RA since 1995; however, regional variation persists across the UK with relative undertreatment, according to established best practice. Improved implementation of evidence-based best clinical practice to facilitate removal of treatment variation is warranted. This may occur as a result of the implementation of published national guidance.},\n\tlanguage = {eng},\n\tnumber = {6},\n\tjournal = {BMJ open},\n\tauthor = {Edwards, Christopher John and Campbell, Jennifer and van Staa, Tjeerd and Arden, Nigel K.},\n\tyear = {2012},\n\tpmid = {23144258},\n\tpmcid = {PMC3533005}\n}\n\n","author_short":["Edwards, C. J.","Campbell, J.","van Staa, T.","Arden, N. K."],"key":"edwards_regional_2012","id":"edwards_regional_2012","bibbaseid":"edwards-campbell-vanstaa-arden-regionalandtemporalvariationinthetreatmentofrheumatoidarthritisacrosstheukadescriptiveregisterbasedcohortstudy-2012","role":"author","urls":{},"downloads":0},"search_terms":["regional","temporal","variation","treatment","rheumatoid","arthritis","descriptive","register","based","cohort","study","edwards","campbell","van staa","arden"],"keywords":[],"authorIDs":[],"dataSources":["FmCWXwJibZiWNzpdc"]}