| Recomm. | Item | Arabian Gulf | Belgium | Czech R. | France | Germany | Italy | Netherlands | Norway | Spain | UK | All countries | |
| 1 | There is no barrier | 29 (32.6) | 37 (44.1) | 23 (31.5) | 234 (56.7) | 151 (50.2) | 66 (38.4) | 31 (42.5) | 31 (43.1) | 53 (44.5) | 22 (19.8) | 677 (44.9) | |
| Consultation time to conduct assessment fully | 21 (23.6) | 22 (26.2) | 19 (26.0) | 55 (13.3) | 72 (23.9) | 47 (27.3) | 33 (45.2) | 20 (27.8) | 59 (49.6) | 45 (40.5) | 393 (26.1) | ||
| 2 | There is no barrier | 16 (18.0) | 20 (23.8) | 17 (23.3) | 145 (35.1) | 140 (46.5) | 46 (26.7) | 16 (21.9) | 25 (34.7) | 18 (15.1) | 13 (11.7) | 456 (30.3) | |
| Lack of time to conduct frequent monitoring | 33 (37.1) | 42 (50.0) | 33 (45.2) | NA | 58 (19.3) | 68 (39.5) | 38 (52.1) | 29 (40.3) | 84 (70.6) | 79 (71.2) | 464 (42.4)* | ||
| 3 | There is no barrier | 28 (31.5) | 33 (39.3) | 13 (17.8) | 138 (33.4) | 107 (35.6) | 32 (18.6) | 50 (68.5) | 30 (41.7) | 26 (21.9) | 25 (22.5) | 482 (32.0) | |
| Insufficient number of qualified health professionals—eg, physiotherapists | 23 (25.8) | 11 (13.1) | 18 (24.7) | 70 (16.9) | 44 (14.6) | 97 (56.4) | 4 (5.5) | 12 (16.7) | 67 (56.3) | 45 (40.5) | 391 (25.9) | ||
| Lack of facilities for education | 19 (21.4) | 10 (11.9) | 19 (26.0) | 122 (29.5) | 59 (19.6) | 62 (36.1) | 2 (2.7) | 11 (15.3) | 60 (50.4) | 14 (12.6) | 378 (25.1) | ||
| 4 | There is no barrier | 10 (11.2) | 16 (19.1) | 16 (21.9) | 72 (17.4) | 79 (26.25) | 14 (8.14) | 34 (46.6) | 23 (31.9) | 9 (7.6) | 24 (21.6) | 297 (19.7) | |
| Lack of patient compliance with recommendations | 49 (55.1) | 51 (60.7) | 47 (64.4) | 214 (51.8) | 121 (40.2) | 74 (43.0) | 24 (32.9) | 28 (38.9) | 63 (52.9) | 39 (35.1) | 710 (47.1) | ||
| Lack of facilities for education | 36 (40.5) | 18 (21.4) | 21 (28.8) | 158 (38.3) | 99 (32.9) | 59 (34.3) | 4 (5.5) | 15 (20.8) | 60 (50.4) | 26 (23.4) | 496 (32.9) | ||
| Insufficient number of qualified health professionals—eg, physiotherapists | 35 (39.3) | 16 (19.1) | 28 (38.4) | 73 (17.7) | 55 (18.3) | 104 (60.5) | 4 (5.5) | 17 (23.6) | 67 (56.3) | 56 (50.5) | 455 (30.2) | ||
| 5 | There is no barrier | 42 (47.2) | 10 (11.9) | 30 (41.1) | 223 (54.0) | 141 (46.8) | 44 (25.6) | 42 (57.5) | 12 (16.7) | 46 (38.7) | 38 (34.2) | 628 (41.7) | |
| Concerns about the safety of long-term use of NSAIDs/COX-2 inhibitor | 34 (38.2) | 50 (59.5) | 37 (50.7) | 117 (28.3) | 95 (31.6) | 73 (42.4) | 17 (23.3) | 42 (58.3) | 48 (40.3) | 57 (51.4) | 570 (37.8) | ||
| 6 | There is no barrier | 29 (32.6) | 17 (20.2) | 25 (34.3) | 223 (54.0) | 160 (53.2) | 79 (45.9) | 41 (56.2) | 11 (15.3) | 64 (53.8) | 65 (58.6) | 714 (47.4) | |
| Fear of addiction/tolerance to opioids with long-term use | 38 (42.7) | 50 (59.5) | 35 (47.9) | 99 (24.0) | 61 (20.3) | 46 (26.7) | 14 (19.2) | 51 (70.8) | 25 (21.0) | 31 (27.9) | 450 (29.9) | ||
| 7 | There is no barrier | 37 (41.6) | 37 (44.1) | 40 (54.8) | 182 (44.1) | 149 (49.5) | 64 (37.2) | 45 (61.6) | 29 (40.3) | 59 (49.6) | 66 (59.5) | 708 (47.0) | |
| Patient concerns about use of corticosteroid injections | 43 (48.3) | 31 (36.9) | 27 (37.0) | 157 (38.0) | 78 (25.9) | 55 (32.0) | 11 (15.1) | 25 (34.7) | 36 (30.3) | 21 (18.9) | 484 (32.1) | ||
| 8 | There is no barrier | 46 (51.7) | 42 (50.0) | 47 (64.4) | 255 (61.7) | 175 (58.1) | 97 (56.4) | 54 (74.0) | 35 (48.6) | 70 (58.8) | 66 (59.5) | 887 (58.9) | |
| 9 | There is no barrier | 21 (23.6) | 24 (28.6) | 5 (6.9) | 175 (42.4) | 119 (39.5) | 55 (32.0) | 43 (58.9) | 22 (30.6) | 49 (41.2) | 13 (11.7) | 526 (34.9) | |
| Insufficient funding | 41 (46.1) | 6 (7.1) | 57 (78.1) | 32 (7.8) | 102 (33.9) | 38 (22.1) | 3 (4.1) | 19 (26.4) | 20 (16.8) | 73 (65.8) | 391 (25.9) | ||
| Administrative burden associated with anti-TNF treatment | 26 (29.2) | 24 (28.6) | 24 (32.9) | 101 (24.5) | 48 (16.0) | 74 (43.0) | 13 (17.8) | 9 (12.5) | 39 (32.8) | 28 (25.2) | 386 (25.6) | ||
| 10 | There is no barrier | 27 (30.3) | 26 (30.9) | 23 (31.5) | 193 (46.7) | 184 (61.1) | 61 (35.5) | 48 (65.8) | 34 (47.2) | 44 (36.9) | 68 (61.3) | 708 (47.0) |
Items ticked by more than 25% of rheumatologists are presented.
For each item: number (percentage) where the item was ticked.
*Percentage of available data.
NA, not available, NSAIDs, non-steroidal anti-inflammatory drugs; Recomm., recommendation; TNF, tumour necrosis factor.