Vol. 6, Issue 2, Part A (2024)

Introduction: Rheumatoid arthritis (RA) is an autoimmune disorder that causes inflammatory arthritis as well as extra-articular manifestations and mostly affects synovial joints. It often begins in small peripheral joints, and it is commonly symmetric. If left untreated, it continues to affect proximal joints. Over time, joint inflammation causes cartilage and bone degradation, resulting in joint degeneration.

Objective: To assess the Management of Rheumatoid Arthritis Patients among General Practitioners.

Methods: We conducted a questionnaire survey targeting the community of GPs patients, operating both in the public and in the private sectors in Netrokona City of the Bangladesh. The questionnaire was sent between January to June 2023. Confidentiality of participants was strictly maintained. The questionnaire included multiple choices questions and one clinical case closely related to good practice guidelines. With this goal in mind, a survey was conducted among GPs operating both in the public and in the private sectors in Bangladesh.

Results: Out of 950 GPs patients selected, 130 GPs responded, representing a participation rate of 13.68%. Returned questions were analyzed, results were expressed as a percentage. Incomplete responses were excluded from the study. 55.3% of GPs worked in the public sector and 46.7% in the private. Mean number of RA patients seen monthly by GPs was 5.75 patients per month. Of all the surveyed GPs, 66.1% had a rheumatologist as a point of contact. With regard to diagnosing RA, half of the GPs were not familiar with the deadline for early diagnosis. Finally, with regard to the role of GPs and within the process of RA collaborative management in tandem with the rheumatologist, 59.2% systematically referred any patient with RA to a rheumatologist, 46.1% felt that they had to make the diagnosis of RA themselves, 77.6% relieved the pain of the patient and left the responsibility for initiating DMARD treatment to the rheumatologist, 79.2% ensured the tolerance monitoring of medication prescribed by a rheumatologist, 68.5% managed the eventual flare-ups of the disease while waiting for the patient to consult with the rheumatologist, 53.8% managed associated co- morbidities associated with RA, and 6.2% thought they could administer a bDMARD themselves.

Conclusion: General practitioners’ practices regarding RA management seemed to be poorly consistent with the recommendations on best practices in most of the studied items. As a matter of fact, the gap was more marked on items in connection with synovitis diagnosis, on the deadline for early RA diagnosis, and on collaborative management modalities with the rheumatologist.