Clinical practice among rheumatologists: managing patients with rheumatoid arthritis

The objective of this study was to review evaluations of current clinical practice among rheumatologists managing patients with rheumatoid arthritis. We reviewed articles retrieved through PubMed using the search terms 'rheumatoid arthritis', 'clinical practice', 'physician's practice patterns', and 'health service research'. We set the time limits at January 1990 and May 2001. Marked variability was found in initial tests, initial treatment, changes in clinical status by number of visits, second-line treatment prescription and monitoring, use of monitoring criteria, clinical outcomes by type of health care insurance, and management of a fictional case. The data were obtained by survey in some studies and by prospective collection in others. This literature review indicates a need for developing recommendations for the management of rheumatoid arthritis.