Comparison of general practitioners and rheumatologists prescription patterns for patients with knee osteoarthritisReport as inadecuate

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BMC Musculoskeletal Disorders

, 12:72

Clinical rheumatology and osteoporosis


BackgroundTo compare the prescription modalities of general practitioners GPs and rheumatologists RHs for symptomatic knee osteoarthritis OA and to determine correlates with prescription of low-dose NSAIDs.

MethodsThis observational, prospective, national survey was carried out among a national representative sample of GPs n = 808 and RHs n = 134. Each physician completed a medical questionnaire for the 2 most recent patients fulfilling the ACR criteria for knee OA.

ResultsGPs and RHs included 1,570 and 251 patients, respectively. Mean pain level of the knee on a VAS, 0-100 mm was greater for GP patients than for RH patients 49.8 ± 16.3 vs. 46.2 ± 17.1 mm, respectively; p < 0.01. As compared with patients of RHs, those of GPs more frequently had another joint affected by OA: 71.2% vs. 63.7% p < 0.0001 and more often had hypertension and diabetes mellitus p < 0.05.

As compared with RHs, GPs more frequently prescribed low-dose NSAIDs p < 0.0001, oral NSAIDs p < 0.05, and topical NSAIDs p < 0.0001 but less frequently symptomatic slow-acting drugs for OA p < 0.01. Moreover, GPs more frequently recommended rehabilitation p < 0.01 and loss of weight p < 0.0001. Logistic regression analysis revealed an association of low-dose NSAIDs prescription and prescription by GPs, prescription of topical NSAIDs, no prescription of oral NSAIDs or coxibs and no intra-articular injection of steroids.

ConclusionsThis study identified speciality-related variability in some aspects of the management of knee OA. The clinical profile of patients with knee OA differed between GPs and RHs.

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Author: Pascal Richette - Pascal Hilliquin - Philippe Bertin - Paolo Carni - Véronique Berger - Marc Marty


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