Session Information
Date: Sunday, November 8, 2015
Title: Health Services Research Poster I: Diagnosis, Management and Treatment Strategies
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Chronic inflammatory arthritis affects around 1% of the general population. Disease-modifying drugs like methotrexate (MTX) and in second-line anti tumor necrosis factor (anti-TNF) therapy are increasingly prescribed, which sometimes puts general practitioners (GP) on the frontline of management for these treatments and their adverse effects. The aim of this study was to explore GPs difficulties with MTX and anti-TNF therapies in routine practice.
Methods:
A questionnaire was sent to 1190 GPs across our local region. We collected and compiled their characteristics, their difficulties in routine practice, and their expectations in terms of facilitating management for these treatments.
Results:
Response rate was 24.9%, i.e. 296 responses, including 11 GPs who refused to participate. Our analysis thus focuses on a dataset of 285 respondents: 57% (n=162) are men, 36% (n=103) are urban-community GPs, 55% (n=157) work in a medical group clinic. Of the 230 GPs following patients on MTX (81%), 113 report difficulties with treatment-related management, chiefly with how to manage infectious episodes (30% of respondents), the onset of side effects (23% of respondents) and drug interactions (31% of respondents). GPs with less than 10 years in practice experience are more difficulties than GPs with more years in practice (66.7% vs 46.6% for 10–30 years in practice and 33.9% for 30-plus years in practice; p=0.002). Just 22% (n=41) of GPs surveyed claimed they are ready to initiate MTX therapy. Of the 189 respondent GPs (66%) following patients on anti-TNF, 127 report exactly the same difficulties but with a higher frequency (infectious complications: 53%; side effects: 29%; drug interactions: 39%). 57.2% of GPs (163/285) perceive anti-TNF therapy have a positive risk–benefit ratio, and 36,2% (105/285) expressed no opinion. 80% of the respondents to this survey (228/285) want dedicated further training.
Conclusion:
This study found that over half of GPs following patients on MTX or anti-TNF therapy experience difficulties managing for these treatments. Dedicated further training on these treatments is a key priority for action.
To cite this abstract in AMA style:
Berthet E, Moiroud V, De Rosa M, Soubrier M, Mathieu S. Exploration of General Practioners’ Difficulties with Methotrexate and Anti-TNF Therapies in Routine Practice [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/exploration-of-general-practioners-difficulties-with-methotrexate-and-anti-tnf-therapies-in-routine-practice/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/exploration-of-general-practioners-difficulties-with-methotrexate-and-anti-tnf-therapies-in-routine-practice/