Table 1.

Guideline adherence parameters

Guideline adherence parameter	Level of measurement
Radiographs of hands, feet and thorax ordered within the first 3 visits, in patients with a disease duration ≤1 year	Patients
Prescription of conventional and biological DMARDs in agreement with the local preferential sequence	Patients
Referral to a specialised nurse within the first 3 visits	Patients
Referral to a PA or NP within the first year of treatment	Patients
Therapy change* in case of moderate-to-high disease activity†	Visits
Regular outpatient clinic visits combined with a nurse-led DAS28 assessment	Visits
Correct intervals between regular outpatient clinic visits	Visits

*Therapy change included the intensification of DMARD therapy (dosage increase, shortening of the interval, adding a new DMARD and/or biological, switching to another DMARD and/or biological), starting or increasing corticosteroids (dose), local corticosteroid injections.

†DAS28>3.2 or corresponding judgement from the rheumatologist if a DAS28 was not available.

DAS28, Disease Activity Score in 28 joints; DMARD, disease modifying anti-rheumatic drug; NP, nurse practitioner; PA, physician assistant.