The assessment of rheumatoid arthritis and the acceptability of self-report questionnaires in clinical practice.

Abstract

To assess the acceptability of self-report questionnaires (SRQ) in clinical practice and to understand the value that rheumatologists give to various assessment methods in rheumatoid arthritis. Rheumatologists who completed a training course in the use of SRQ in clinical trials and clinical practice used the SRQ in their practices. Six months later 221 rheumatologists completed a survey regarding their experiences in assessing rheumatoid arthritis and in the use of SRQ. Prior to the start of the program, 18% of rheumatologists used self-report questionnaires, 6 months later, 48% were using SRQ in their practices. Rheumatologists who did not use questionnaires placed less value on all assessment methods, and particularly on questionnaire assessments of function and pain. They also were more likely to report that questionnaires were difficult to use, not accepted by staff, were too long, and that they had limited staff. Rheumatologists who used the questionnaires reported none of these difficulties and were satisfied with the benefits provide by SRQ. When assessment measures were ranked, rheumatologist ranked ACR 20, radiography, and erythrocyte sedimentation rate/c-reactive protein as the least important in both clinical trials and in clinical practice, and they rated swollen and tender joint counts followed by SRQ as the most useful assessment tools. SRQ are well received by rheumatologists, and following a training program almost 50% continued to use SRQ in their practices. Those who used questionnaires were generally more positive about assessments and had little difficulty in the technical aspects of administration, scoring, and interpretation.