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Ten recommendations for the use of methotrexate were recently developed, based on published data and expert opinion in the 3E initiative1 (table 1). Clinical guidelines may induce small improvements both in processes and in the outcomes of care.2 However, if recommendations are to have effect, it is necessary after they have been published to facilitate their dissemination.3 In order to improve the implementation of these recommendations in daily practice, an initiative was performed in 2008 according to published methodology4 which aimed …
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