Health care provision in pediatric rheumatology in Germany--national rheumatologic database.

OBJECTIVE

To describe the health care provision for children and adolescents with chronic arthritides in Germany in 1998.

METHODS

Data were analyzed from the German pediatric rheumatologic database of the year 1998. It contains clinical and patient questionnaire data for 2488 patients with rheumatic diseases seen at 18 pediatric rheumatology units.

RESULTS

A total of 1811 of all patients recorded in the database had chronic arthritides--931 with juvenile chronic arthritis, 86 with juvenile spondyloarthropathy, and 65 with juvenile psoriatic arthritis were considered in the analysis. These patients seen by pediatric rheumatologists had a median age of 10 years and a median disease duration of 4 years. The majority were being treated at pediatric rheumatology disease centers and at universities. Nonsteroidal antiinflammatory drugs were the most commonly used drugs for all forms of chronic arthritides. Almost half the patients with chronic arthritides received disease modifying antirheumatic drugs, with methotrexate the most frequently prescribed agent. While the majority of patients reported having physiotherapy, low prescription rates were noted for comprehensive measures such as occupational therapy and patient education. Only a few patients showed severe functional limitation, 2% of them being rated in Steinbrocker class III or higher. While the patients' functional limitation correlated with disease activity, neither disease duration nor sex, arthritis subgroup nor time span to the first visit at the rheumatology unit had any relevant influence on functional status.

CONCLUSION

The data reveal the spectrum of patients with chronic arthritides seen by German pediatric rheumatologists, as well as the treatment patterns of their physicians.