Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Clin Rheumatol. 2021 Jul;40(7):2681-2688. doi: 10.1007/s10067-021-05607-9. Epub 2021 Jan 31.
To assess rheumatology health care providers' (HCPs) knowledge, beliefs, self-efficacy, practices, and perceived barriers pertaining to weight management and smoking cessation counselling in patients with rheumatoid arthritis (RA).
We administered an online survey to collect self-reported data on rheumatology HCPs' knowledge, beliefs, self-efficacy, perceived barriers, and practices related to weight management and smoking cessation counselling. Participants were recruited through invitation emails (with anonymous survey links) sent by three Canadian rheumatology organizations.
Fifty-nine rheumatology HCPs (15 nurses, 44 physicians) completed the survey (response rate: 11%). Over 85% correctly identified associations between obesity, or smoking, and more severe or active RA, as well as poorer response to treatment. All but one participant agreed that it was part of their responsibility to discuss these issues with patients, but 78% (46/59) felt not or slightly confident in their ability to help patients quit smoking or achieve clinically significant weight loss. The majority did not routinely assist patients in accessing appropriate resources or providers (only 42% did for obesity, 36% for smoking), send referrals (2-44%, depending on referral), or offer relevant educational materials (15% for obesity, 20% for smoking). Common barriers included competing demands and lack of time, training, access to expertise, and knowledge of available programs.
Most rheumatology HCPs understood the implications of cigarette smoking and obesity in RA and accepted responsibility in addressing these issues. However, they lacked the time, training, confidence, and knowledge of local resources to do so effectively. There is a need to bridge this gap. Key Points • Training through medical and nursing school as well as residency on weight management and smoking cessation counselling was nearly unanimously described as poor or fair. • Most rheumatology health care providers understood the implications of cigarette smoking and obesity in rheumatoid arthritis and accepted responsibility in addressing these issues; however, they lacked the time, training, confidence, and knowledge of local resources to do so effectively. • There is a need to bridge the gap between health care providers' intentions and actions, and this may include the development of guides outlining local weight management and smoking cessation expertise, programs, referral processes, and educational materials.
评估风湿病医疗保健提供者（HCPs）在类风湿关节炎（RA）患者的体重管理和戒烟咨询方面的知识、信念、自我效能、实践和感知障碍。
我们进行了一项在线调查，以收集有关风湿病 HCPs 与体重管理和戒烟咨询相关的知识、信念、自我效能、感知障碍和实践的自我报告数据。参与者是通过三个加拿大风湿病组织发送的邀请电子邮件（带有匿名调查链接）招募的。
59 名风湿病 HCPs（15 名护士，44 名医生）完成了调查（应答率：11%）。超过 85%的人正确识别出肥胖或吸烟与更严重或更活跃的 RA 以及对治疗的反应较差之间的关联。除一名参与者外，所有人都认为讨论这些问题是他们的责任，但 78%（46/59）的人认为自己在帮助患者戒烟或实现临床显著体重减轻方面没有或只有一点信心。大多数人没有定期帮助患者获得适当的资源或提供者（只有 42%对肥胖，36%对吸烟），发送转介（2-44%，取决于转介）或提供相关教育材料（15%对肥胖，20%对吸烟）。常见的障碍包括需求竞争和缺乏时间、培训、获得专业知识以及对现有计划的了解。
大多数风湿病 HCPs 理解吸烟和肥胖对 RA 的影响，并接受了在解决这些问题方面的责任。然而，他们缺乏有效的时间、培训、信心和对当地资源的了解。需要弥合这一差距。关键点•医学和护理学校以及住院医师培训中关于体重管理和戒烟咨询的培训几乎一致被描述为差或一般。•大多数风湿病医疗保健提供者理解吸烟和肥胖对类风湿关节炎的影响，并接受在解决这些问题方面的责任；然而，他们缺乏有效的时间、培训、信心和对当地资源的了解。•需要弥合医疗保健提供者的意图和行动之间的差距，这可能包括制定概述当地体重管理和戒烟专业知识、计划、转介流程和教育材料的指南。
