Primary care physicians perspectives towards managing rheumatoid arthritis room for improvement 英文参考文献.docVIP
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Primary care physicians perspectives towards managing rheumatoid arthritis room for improvement 英文参考文献
Garneauetal.ArthritisResearchTherapy2011,13:R189
/content/13/6/R189
RESEARCH ARTICLE
OpenAccess
Primarycarephysicians’perspectivestowards
managingrheumatoidarthritis:roomfor
improvement
KatieLGarneau1,MauraDIversen1,2,HsunTsao1andDanielHSolomon1,3*
Abstract
Introduction:Manypeoplewithrheumatoidarthritis(RA)donotreceivecarefromarheumatologist.Wesurveyed
primarycarephysicians(PCPs)tobetterunderstandtheirattitudes,knowledge,andpracticesregardingtheoptimal
treatmentofRA.
Methods:RandomlyselectedPCPspracticingintheUSweresurveyed.Thesurveyencompassedtheirexperience
withRA,useofdiseasemodifyinganti-rheumaticdrugs(DMARDs),andexperiencewithrheumatologyreferrals.
Logisticregressionanalysesdescribedtheresponsesandexaminedthecorrelationbetweenphysicianvariablesand
useofDMARDs.
Results:E-mailinvitationswereopenedby1,103PCPsandcompletedby267(25%).Mostrespondentsweremen
(68%)inpracticeforover10years(64%)whoreported6ormoreRApatientsundertheircareinthelastyear
(71%).ThemajorityreportedsomeRAtrainingaftermedicalschool(59%),butonlyone-thirdfeltveryconfident
managingthiscondition.Most(81%)reportedprescribingDMARDs,but37%donotinitiatethem,withonly9%
reportingbeingveryconfidentstartingaDMARD.Inunadjustedanalyses,severalrespondentcharacteristicswere
stronglyassociatedwithnotprescribingDMARDs,butnonewassignificantafteradjustment.Almosthalf(44%)of
PCPsnotedthatpatientsreportdifficultygettingappointmentswithrheumatologists.
Conclusions:WefoundmanyPCPsareuncomfortablemanagingRAwithDMARDs,despitecommonbeliefsthat
theirpatientslackaccesstoarheumatologist.Lackofaccessibilitytorheumatologistsanddiscomfortinprescribing
DMARDsforpatientswithRAarepotentialbarrierstooptimaltreatment.
Introduction
Thestrongest correlate ofDMARDuseacross multi-
Rheumatoidarthritis (RA)isthemostcommontypeof plestudiesistheinvolvementofarheumatologistinthe
systemic inflammatory arthritis and causes substantial care of patients with RA [5,7]. Investigators have esti-
painanddisability[1].ThestandardofcareforRAhas
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