School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Intern Med J. 2012 Jul;42(7):801-7. doi: 10.1111/j.1445-5994.2011.02586.x.
Inflammatory bowel disease (IBD) is a chronic disease requiring long-term management. General practitioners (GPs) are often the first point of contact for initial symptoms and flares. Thus we assessed GPs' attitudes to and knowledge of IBD.
A state-wide postal survey of GPs was performed collecting demographic details, practice and attitudes in IBD-specific management and knowledge.
Of 1800 GPs surveyed in South Australia, 409 responded; 58% were male, 80% Australian trained and 73% practised in metropolitan areas. Most GPs (92%) reported seeing zero to five IBD patients per month. Overall, 37% of the GPs reported being generally 'uncomfortable' with IBD management. Specifically, they were only somewhat comfortable in providing/using maintenance therapy, steroid therapy or unspecified therapy for an acute flare. They were uncomfortable with the use of immunomodulators and biologicals (71 and 91% respectively). No GP reported never referring, referring sometimes (12%), often (34%) or always (55%). Most (87%) GPs rated their communication with private specialists positively; while only 32% were satisfied with support from public hospitals. Of concern, most (70%) monitored patients on immunosuppression on a case-by-case basis rather than by protocol. In multivariable analyses, GPs' IBD-specific knowledge did not influence comfort with overall management, nor did knowledge influence GP comfort with any particular therapy.
Individual GPs care for few IBD patients and have variable attitudes in their practice. Whether improvement can realistically be achieved given individual GP's paucity of patients is questionable. These data support the provision of better support and specific action plans for IBD patients.
炎症性肠病（IBD）是一种需要长期管理的慢性病。全科医生（GP）通常是最初症状和发作的第一接触点。因此，我们评估了 GP 对 IBD 的态度和知识。
对南澳大利亚州的全科医生进行了一项全州范围的邮寄调查，收集人口统计学细节、IBD 特定管理和知识方面的实践和态度。
在接受调查的 1800 名南澳大利亚州全科医生中，有 409 名做出了回应；58%为男性，80%为澳大利亚培训，73%在大都市区行医。大多数 GP（92%）报告每月看零到五个 IBD 患者。总体而言，37%的 GP 报告对 IBD 管理普遍“感到不适”。具体来说，他们在提供/使用维持治疗、类固醇治疗或急性发作的未指明治疗方面只是有些不舒服。他们对免疫调节剂和生物制剂的使用感到不适（分别为 71%和 91%）。没有 GP 报告从未转诊、有时转诊（12%）、经常转诊（34%）或总是转诊（55%）。大多数（87%）GP 对与私人专家的沟通评价较高；而只有 32%对公立医院的支持感到满意。值得关注的是，大多数（70%）GP 根据具体情况而不是根据方案监测接受免疫抑制治疗的患者。在多变量分析中，GP 的 IBD 特定知识并未影响总体管理的舒适度，知识也未影响 GP 对任何特定治疗的舒适度。
个别 GP 照顾的 IBD 患者较少，在实践中态度也各不相同。鉴于个别 GP 患者数量较少，是否能够切实改善这种情况值得怀疑。这些数据支持为 IBD 患者提供更好的支持和具体行动计划。
