Knowledge of General Practitioner’s toward Spondyloarthritis (SpA): A Qualitative Study
DOI:
https://doi.org/10.21776/ub.crjim.2022.003.02.4Keywords:
general practitioner, primary care, physician, spondyloarthritis, inflammatory, back painAbstract
Background: Low back pain (LBP) is one of major health problems experienced by 80-85% of patients in their lifetime. Spondyloarthritis (SpA) has become one of the leading causes of chronic LBP but is often undiagnosed. General practitioners (GP) have an essential role in the early diagnosis of SpA.
Aim: To explore the knowledge of GP about SpA from clinical diagnosis and early management and elaborate on each GP’s clinical perspective and practice performance.
Methods: A qualitative study that involved 12 GP. All was consented to participate in an in-depth interview with the experts by online meeting with 15-20 minutes duration. Analysis was focused on the definition, classification, clinical manifestation, diagnosis, and early management of SpA in primary care.
Results: All GP were interviewed (12 GP, 9 men, and 3 women; mean age 29.42) with average years in clinical practice was 3.8 years. All GP could describe the definition of SpA. Only a few subjects are aware of the subtype of SpA. Most of the GP could mention chronic back pain as the main SpA symptom, some GP mentioned extra-articular manifestation, but incomplete. All GP understood the current treatment in clinical practice.
Conclusion: GP is aware of SpA, but not all could completely mention the type and clinical entities. In addition, a limited resource for investigation makes a diagnosis of SpA difficult. Current early treatment has been acceptable in clinical practice. A comprehensive understanding of diagnosis and effective early treatment may reduce delayed diagnosis and improve patients' quality of life.
References
Walsh JA. Recognizing Axial Spondyloarthritis: A Guide for Primary Care. Mayo Clin Proc [Internet]. 2020;95(11):2499–508. Available from: https://doi.org/10.1016/j.mayocp.2020.02.007
Islami NANN, Akbar IB, Hakim FA. Gambaran Faktor Risiko Pasien Nyeri Punggung Bawah di RSUD Kota Bandung Periode Januari-Desember 2018. Pros Kedokt. 2020;6(1):465–8.
Indonesia PR. Diagnosis dan Pengelolaan. 2021.
Lapane KL, Shridharmurthy D, Khan S, Lindstrom D, Beccia A, Yi E, et al. PLOS ONE Primary care physician perspectives on screening for axial spondyloarthritis : A qualitative study. 2021;1–13. Available from: http://dx.doi.org/10.1371/journal.pone.0252018
Maksymowych WP, Morency N, Conner-Spady B, Lambert RG. Suppression of inflammation and effects on new bone formation in ankylosing spondylitis: Evidence for a window of opportunity in disease modification. Ann Rheum Dis. 2013;72(1):23–8.
Juanola Roura X, Collantes Estévez E, León Vázquez F, Torres Villamor A, García Yébenes MJ, Queiro Silva R, et al. Reccomendations for the detection, study and referral of inflammatory low-back pain in Primary Care. Reumatol Clin. 2015;11(2):90–8.
Lapane KL, Shridharmurthy D, Khan S, Lindstrom D, Beccia A, Yi E, et al. Primary care physician perspectives on screening for axial spondyloarthritis: A qualitative study. PLoS One. 2021;16(5 May):1–11.
Domain T, Occupation C, Experience G, Method S, Setting NS, Data D, et al. COREQ ( COnsolidated criteria for REporting Qualitative research ) Checklist. :18–9.
Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: Developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758–72.
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968–74.
Van Onna M, Gorter S, Van Meerendonk A, Van Tubergen A. General practitioners’ perceptions of their ability to identify and refer patients with suspected axial spondyloarthritis: A qualitative study. J Rheumatol. 2014;41(5):897–901.
Van Onna M, Gorter S, Maiburg B, Waagenaar G, Van Tubergen A. Education improves referral of patients suspected of having spondyloarthritis by general practitioners: A study with unannounced standardised patients in daily practice. RMD Open. 2015;1(1):1–9.
Jois RN, Macgregor AJ, Gaffney K. Recognition of inflammatory back pain and ankylosing spondylitis in primary care. Rheumatology. 2008;47(9):1364–6.
Van Der Heijde D, Ramiro S, Landewé R, Baraliakos X, Van Den Bosch F, Sepriano A, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76(6):978–91.
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