Alnaqbi Khalid A, Alaswad Mohammed, Mahmoud Amr A A, Hannawi Suad
Division of Rheumatology, Sheikh Tahnoon Medical City, PureHealth, Al Ain, UAE.
Faculty of Human Medicine, University of Hama, Hama, Syria.
Rheumatol Int. 2025 May 5;45(5):134. doi: 10.1007/s00296-025-05889-1.
Managing rheumatic diseases requires teamwork, but referral patterns and challenges remain poorly understood. This study explored rheumatologists' perspectives on referral patterns in the Gulf countries. We conducted a web-based, 21-question cross-sectional survey between November and December 2024, collecting data on rheumatologists' demographics, referral patterns, influencing factors, and satisfaction. Participants were recruited through email invitations, WhatsApp groups and snowball sampling. Statistical analyses included descriptive and inferential methods, such as subgroup comparisons and logistic regression, to identify predictors of referral frequency and satisfaction. A total of 149 rheumatologists participated, with 58.4% being consultants. Approximately 55% had up to 10 years of post-training experience. The primary referral method was electronic health records (EHR) (84.8%). In the three months preceding the survey, 36.3% made 0-10 referrals, while 35.6% made over 20. Dermatology (85.5%) and physiotherapy (79.5%) were the most referred specialties, aligning with psoriatic arthritis and systemic lupus erythematosus as the most referred diseases. Most rheumatologists (78%) often or always followed up on referrals, and 37.4% reported moderate changes in their referral decision-making over time. Key influences on referral decisions included patient-, practice-, and diagnostic-related factors. Patient gender preference had no impact. Multidisciplinary meetings (78.2%), access to updated clinical guidelines (76.5%), attending multidisciplinary continuing medical education or training programs (67.2%), and improved EHR referral systems (64.7%) were the top resources for improving referrals. Satisfaction post-referral was affected by various factors such as patients' experiences post-referral (61.5%), and healthcare professionals' responsiveness to their questions (54.2%). Logistic regression analysis showed that age, employment status, practice setting, and geographical location were associated with referral decisions. This study is the first to provide valuable insights into referral practices among Gulf rheumatologists, identifying key influencing factors and areas for improvement. Findings suggest that enhancing EHR systems, multidisciplinary meetings, and clinical guidelines can optimize referrals and interdisciplinary care.
管理风湿性疾病需要团队合作，但转诊模式和挑战仍未得到充分了解。本研究探讨了海湾国家风湿病专家对转诊模式的看法。我们在2024年11月至12月期间开展了一项基于网络的、包含21个问题的横断面调查，收集了有关风湿病专家的人口统计学信息、转诊模式、影响因素和满意度的数据。参与者通过电子邮件邀请、WhatsApp群组和滚雪球抽样的方式招募。统计分析包括描述性和推断性方法，如亚组比较和逻辑回归，以确定转诊频率和满意度的预测因素。共有149名风湿病专家参与，其中58.4%为顾问。约55%的人有长达10年的培训后经验。主要的转诊方式是电子健康记录（EHR）（84.8%）。在调查前的三个月里，36.3%的人转诊0至10次，而35.6%的人转诊超过20次。皮肤科（85.5%）和物理治疗（79.5%）是转诊最多的专科，这与银屑病关节炎和系统性红斑狼疮是转诊最多的疾病相吻合。大多数风湿病专家（78%）经常或总是对转诊进行跟进，37.4%的人报告说他们的转诊决策随时间有适度变化。转诊决策的关键影响因素包括与患者、执业和诊断相关的因素。患者性别偏好没有影响。多学科会议（78.2%）、获取最新临床指南（76.5%）、参加多学科继续医学教育或培训项目（67.2%）以及改进EHR转诊系统（64.7%）是改善转诊的首要资源。转诊后的满意度受到多种因素的影响，如患者转诊后的经历（61.5%）以及医疗保健专业人员对他们问题的回应（54.2%）。逻辑回归分析表明，年龄、就业状况、执业环境和地理位置与转诊决策有关。本研究首次为海湾地区风湿病专家的转诊实践提供了有价值的见解，确定了关键影响因素和改进领域。研究结果表明，加强EHR系统、多学科会议和临床指南可以优化转诊和跨学科护理。
