Table I.

Nonconformity with EULAR recommendations in clinical practice in Poland

EULAR recommendations for RA patients	Declarative estimates as stated by rheumatologists
	Inconsistency in applying recommendations in practice	Mean % patients
Therapy with csDMARDs should be started as soon as the diagnosis of RA is made	Treatment not initiated at diagnosis	15
	Lag time in treatment initiation from diagnosis (> 3 months)	29
Treatment should be aimed at reaching a target of sustained remission or low disease activity in every patient	Never achieving remission	64
	Time to first-ever remission (> 6 months)	54
	Sustained remission (> 12 months)	19
Monitoring should be frequent in active disease (every 1–3 months); if there is no improvement by at most 3 months after the start of treatment or the target has not been reached by 6 months, therapy should be adjusted	Interval of disease activity monitoring (> 3 months)	33
MTX should be part of the first treatment strategy	Lack of MTX use in monotherapy or in combination with GC and/or other csDMARDs	10–12
Short-term glucocorticoids should be considered when initiating or changing csDMARDs, in different dose regimens and routes of administration, but should be tapered as rapidly as clinically feasible	GC treatment time (> 6 months)	25
If the treatment target is not achieved with the first csDMARD strategy, when poor prognostic factors are present, addition of a bDMARD or a tsDMARD should be considered; current practice would be to start a bDMARD	No bDMARD treatment planned (despite active disease after ≥ 2 treatment schemes/drugs)	34
	Referred for bDMARD treatment (active disease only after ≥ 3 treatment schemes/drugs)	51