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Too few patients with rheumatoid arthritis are receiving disease-modifying anti-rheumatic drugs, and the situation is not improving, a study concludes.

Researchers blamed GPs' lack of training in musculoskeletal conditions and said they did not refer patients to specialists often enough.

The study, presented at the British Society for Rheumatology annual conference in Birmingham this week, examined 34,364 patients from the UK general practice research database. Over a 15-year period the proportion of patients taking DMARDs did not change, beginning and ending on 50 per cent.

Research leader Dr Chris Edwards, a consultant rheumatologist and senior lecturer in Southampton University Hospitals NHS Trust, said: 'Some of it's lack of referral and some of it's lack of training in musculoskeletal research. There is a lack of awareness among medics in general about the severity of RA. It's a bad disease, it's under-estimated by people and we don't treat it well.'

His colleague Dr Nigel

Arden, a senior lecturer and consultant rheumatologist in Southampton, added 'the majority' of patients with RA should be on a DMARD.

A second study presented at the BSR conference found that only 56 per cent of patients on DMARDs monitored by GPs were checked at the correct intervals, compared with 79 per cent by

specialists.

Researcher Elaine Healey, a rheumatology nurse specialist at St Mary's Hospital in the Isle of Wight, said GPs did not feel confident using the drugs.

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