Abstract
The Network Of Rheumatic Disease In Shinshu (NORDIS) was established in November 2007 under the principle that every patient with rheumatoid arthritis (RA) should be treated with the best possible therapy in all areas of Nagano prefecture. Eighty five medical institutes actively participate in NORDIS. According to an annual questionnaire performed since 2006, orthopaedic surgeons account for approximately 80 percent of NORDIS members, and 17 percent of all members treat a large number of RA patients. Survey data from 2008 revealed that only 35 percent of members used biologics to treat RA. However, 72 percent of respondents who did not use biologics responded that they would accept patients treated with these drugs with the assistance of a rheumatologist. This implies that cooperation is needed among clinics and hospitals when complications occur to assure the spread of biologic use. It was also evident from survey findings that most patients who participated in the extension course for citizens understood their treatment and wanted to receive better therapy. As treatments for RA improve, more doctors and patients are informing themselves about new options. Thus, doctors need to decide their role in RA therapy and medical treatment to promote better collaboration among healthcare facilities.
