An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists

Donskov AO, Mackie SL, Hauge EM, Toro-Gutierrez CE, Hansen IT, Hemmig AK, Van Der Maas A, Gheita T, Nielsen BD, Douglas KMJ, Conway R, Rezus E, Dasgupta B, Monti S, Matteson EL, Sattui SE, Matza M, Ocampo V, Gromova M, Grainger R, Bran A, Appenzeller S, Goecke A, Colman N, Keen H, Kuwana M, Gupta L, Salim B, Harifi G, Erraoui M, Ziade N, Al-Ani NA, Ajibade A, Knitza J, Frolund L, Yates M, Pimentel-Quiroz VR, Lyrio AM, Sandovici M, Van Der Geest KSM, Helliwell T, Brouwer E, Dejaco C, Keller KK (2023)

Publication Type: Journal article

Publication year: 2023

Journal

DOI: 10.1093/rheumatology/keac713

Abstract

Objectives To explore current management practices for PMR by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment. Methods An English language questionnaire was constructed by a working group of rheumatologists and GPs from six countries. The questionnaire focused on: 1: Respondent characteristics; 2: Referral practices; 3: Treatment with glucocorticoids; 4: Diagnostics; 5: Comorbidities; and 6: Barriers to research. The questionnaire was distributed to rheumatologists and GPs worldwide via members of the International PMR/Giant Cell Arteritis Study Group. Results In total, 394 GPs and 937 rheumatologists responded to the survey. GPs referred a median of 25% of their suspected PMR patients for diagnosis and 50% of these were returned to their GP for management. In general, 39% of rheumatologists evaluated patients with suspected PMR >2 weeks after referral, and a median of 50% of patients had started prednisolone before rheumatologist evaluation. Direct comparison of initial treatment showed that the percentage prescribing >25 mg prednisolone daily for patients was 30% for GPs and 12% for rheumatologists. Diagnostic imaging was rarely used. More than half (56%) of rheumatologists experienced difficulties recruiting people with PMR to clinical trials. Conclusion This large international survey indicates that a large proportion of people with PMR are not referred for diagnosis, and that the proportion of treatment-naive patients declined with increasing time from referral to assessment. Strategies are needed to change referral and management of people with PMR, to improve clinical practice and facilitate recruitment to clinical trials.

Authors with CRIS profile

Involved external institutions

Aarhus University Hospital / Aarhus Universitetshospital Denmark (DK) University of Leeds United Kingdom (GB) Universitätsspital Basel Switzerland (CH) Sint Maartenskliniek Netherlands (NL) Cairo University Egypt (EG) Regional Hospital Horsens / Regionshospitalet Horsens Denmark (DK) Russells Hall Hospital United Kingdom (GB) St. James's Hospital Ireland (IE) Grigore T. Popa University of Medicine and Pharmacy / Universitatea de Medicină și Farmacie "Grigore T. Popa" (UMF Iași) Romania (RO) Southend Hospital United Kingdom (GB) Massachusetts General Hospital United States (USA) (US) Hospital Base Guillermo Almenara Irigoyen Peru (PE) Pontifícia Universidade Católica de Campinas Brazil (BR) Policlinico San Matteo Pavia Fondazione IRCCS Italy (IT) Mayo Clinic United States (USA) (US) University of Pittsburgh United States (USA) (US) Scarborough Health Network Canada (CA) Pirogov Russian National Research Medical University (RSMU / RNRMU) Russian Federation (RU) University of Otago New Zealand (NZ) Universidad Francisco Marroquín (UFM) Guatemala (GT) Universidade Estadual de Campinas (UNICAMP) / University of Campinas Brazil (BR) Hospital Clínico de la Universidad de Chile (HCUCH) Chile (CL) Universidad Nacional de Asunción (UNA) Paraguay (PY) Fiona Stanley Hospital Australia (AU) Nippon Medical School Japan (JP) The Royal Wolverhampton NHS Trust / Royal Wolverhampton Hospitals NHS Trust United Kingdom (GB) Fauji Foundation Hospital Pakistan (PK) Mediclinic Middle East / ميديكلينيك الشرق الأوسط United Arab Emirates (AE) Université Ibnou Zohr Morocco (MA) Université Saint-Joseph (USJ) / جامعة القديس يوسف / Սուրբ Ժոզեֆի համալսարան Lebanon (LB) University of Baghdad Iraq (IQ) University of East Anglia United Kingdom (GB) University of Groningen / Rijksuniversiteit Groningen Netherlands (NL) Staffordshire University Germany (DE)

How to cite

APA:

Donskov, A.O., Mackie, S.L., Hauge, E.M., Toro-Gutierrez, C.E., Hansen, I.T., Hemmig, A.K.,... Keller, K.K. (2023). An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists. Rheumatology. https://dx.doi.org/10.1093/rheumatology/keac713

MLA:

Donskov, Agnete Overgaard, et al. "An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists." Rheumatology (2023).

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