Omair Mohammed A, Omair Maha A, Halabi Hussein
Division of rheumatology, Department of Medicine, King Khalid University hospital, College of medicine, King Saud University, Riyadh, Saudi Arabia.
Department of statistics, College of Science, King Saud University, Riyadh, Saudi Arabia.
Int J Rheum Dis. 2017 Sep;20(9):1185-1192. doi: 10.1111/1756-185X.12735. Epub 2015 Sep 10.
Currently there are no national recommendation guidelines for the management of rheumatoid arthritis (RA) in Saudi Arabia, which has led to a lack of standard of care. The aim of this study is to explore RA management strategies in practicing rheumatologists in Saudi Arabia.
A 38 questions survey was designed using an electronic website. The survey was distributed through the official email of the Saudi Society for Rheumatology. Rheumatologists with at least 1 year of experience were included. Descriptive analysis was used to report demographics and participants' answers. Chi-square and Fischer's exact test were used to evaluate the relation between the characteristics of participants and their answers.
Out of 120 registered practicing adult rheumatologists, 54 (45%) completed the survey. The majority were male 31 (57.4%) and Saudis 36 (66.7%). Forty-two participants (77.8%) use clinical outcome measures in daily clinical practice to guide treatment decisions with the majority using the Disease Activity Score of 28 joints (61.1%). Quality of life measures were used by 22 (40.7%) participants with statistically significant male predominance (P = 0.043). Time consumption was the most important cause for not using any outcome measures. Thirteen (24.1%) and 17 (31.5%) participants do not use parenteral methotrexate and leflunomide, respectively, because of unavailability in the hospital formulary. Nine (16.7%) and 38 (70.37%) participants do not see a role for tofacitinib and biosimilars, respectively, in the management of RA.
This survey has highlighted many areas of improvement in the practice of rheumatologists in Saudi Arabia and should be the focus of future educational activities.
沙特阿拉伯目前尚无关于类风湿关节炎(RA)管理的国家推荐指南,这导致了护理标准的缺失。本研究的目的是探讨沙特阿拉伯执业风湿病学家的RA管理策略。
使用电子网站设计了一份包含38个问题的调查问卷。该问卷通过沙特风湿病学会的官方电子邮件进行分发。纳入至少有1年经验的风湿病学家。采用描述性分析报告人口统计学和参与者的答案。使用卡方检验和费舍尔精确检验来评估参与者特征与其答案之间的关系。
在120名注册执业成人风湿病学家中,54名(45%)完成了调查。大多数为男性,共31名(57.4%),沙特人36名(66.7%)。42名参与者(77.8%)在日常临床实践中使用临床结局指标来指导治疗决策,其中大多数使用28个关节的疾病活动评分(61.1%)。22名(40.7%)参与者使用生活质量指标,男性占主导且具有统计学意义(P = 0.043)。时间消耗是不使用任何结局指标的最重要原因。分别有13名(24.1%)和17名(31.5%)参与者因医院处方中没有而不使用胃肠外甲氨蝶呤和来氟米特。分别有9名(16.7%)和38名(70.37%)参与者认为托法替布和生物类似药在RA管理中无作用。
本次调查突出了沙特阿拉伯风湿病学家实践中许多需要改进的方面,应成为未来教育活动的重点。