Insights into the knowledge, attitude and practices for the treatment of idiopathic inflammatory myopathy from a cross-s
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Rheumatology International https://doi.org/10.1007/s00296-020-04695-1
INTERNATIONAL
OBSERVATIONAL RESEARCH
Insights into the knowledge, attitude and practices for the treatment of idiopathic inflammatory myopathy from a cross‑sectional cohort survey of physicians Latika Gupta1 · Hafis Muhammed1 · R. Naveen1 · Rajat Kharbanda1 · Harikrishnan Gangadharan1 · Durga P. Misra1 · James B. Lilleker2,3 · Hector Chinoy3,4,5 · Vikas Agarwal1 Received: 6 July 2020 / Accepted: 24 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The idiopathic inflammatory myopathies (IIM) are heterogeneous and lead to high morbidity and mortality. Knowledge deficits among healthcare professionals could be detrimental to clinical care. Identifying areas of deficient Knowledge, Attitude and Practice (KAP) of IIM can improve physician education and patient outcomes. To assess the proportion of physicians treating IIM with poor KAP and identify the key areas of deficit. An anonymised and validated e-survey (57 questions) was circulated among physicians treating IIM (purposive sampling). Responses were evaluated using the Likert scale for good (> 70% correct response), poor (> 20% chose > 2 answers) and the rest as intermediate consensus. Descriptive statistics were used. Intergroup comparisons were done using non-parametric tests. Of 80 (9.1% of 883) respondents, 90% were rheumatologists and 37.5% academicians. The knowledge base of treating physicians was good in specific domains such as triggers (80–90%), clinical presentation (MDA5, statin myositis, steroid myopathy, anti-synthetase syndrome) (82–92%), IIM mimics (41–89%), investigations (23–92%) and risk of osteoporosis in IIM (79%). There is also an intermediate knowledge base/consensus for outcome measures (30–56%) and response criteria (30–53%). There was poor knowledge and consensus on trials (27–34%), EULAR/ACR criteria (31%) and exercise-based interventions (17–62%). While 90% agree on the need for muscle biopsy to diagnose polymyositis, only one-third advocated it for juvenile and adult DM. Physicians have a good understanding of the triggers, clinical presentation and mimics of IIM. Poor to intermediate knowledge and consensus exists regarding muscle biopsy, outcome measures, response criteria and exercise-based interventions, which could be addressed through future focussed educational initiatives. Keywords Myositis · Questionnaire · Knowledge, attitudes, practice · Survey
Introduction The idiopathic inflammatory myopathies (IIM) are a rare and heterogeneous group of diseases that often result in considerable morbidity and mortality. For many years, IIM was classified simply as either polymyositis (PM) or dermatomyositis (DM) [1]. However, the identification of several myositis-specific antibodies (MSA) and associated Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00296-020-04695-1) contains supplementary material, which is available to authorized users. * Vikas Agarwal vikasagr@
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