Aim Implementation of treat‐to‐target (T2T) for rheumatoid arthritis (RA) presents many challenges and an evidence‐practice gap has emerged. This study assessed clinician and patient barriers to the implementation of an RA‐T2T strategy and developed a knowledge translation (KT) tool for use in “real‐life” clinical settings. Methods Surveys of patients and rheumatologists measured agreement with RA‐T2T recommendations and use in daily practice. Patient knowledge and perceptions were assessed as was clinician willingness to alter practice and barriers to RA‐T2T using visual analog scales. An electronic KT‐tool was developed and a two‐phase usability trial undertaken to assess use in clinical interactions. Results Ninety‐one percent of patients had no prior knowledge of RA‐T2T but agreed with the recommendations showing mean level agreement scores (8.39‐9.54, SD 2.37‐1.54). Ninety percent were willing to try RA‐T2T, 49% felt their treatment could be improved and 28% wanted more involvement in treatment decisions. Rheumatologists agreed with RA‐T2T recommendations (7.30‐9.27, SD 2.59‐0.91). Barriers to implementation identified by rheumatologists included time, appointment availability and perceived patient reluctance to escalate medications. Usability experiences with the KT‐tool were tracked and clinicians reported it was easy to use (100%), resulted in a discussion of RA‐T2T (73%) and a target being set for 63% of consults. Patients reported they read (92%) and understood (87%) the information in the KT‐tool, and that a target was set in 62% of interactions. Conclusions RA‐T2T uptake in clinical practice may be improved through understanding local clinician and patient barriers and an implementation strategy utilizing a patient‐driven KT‐tool.

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