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AB0814-PC The patients with osteoarthritis and the primary care of general practitioners
  1. N. Nikolov1,
  2. M. Panchovska2,
  3. Z. Kolarov3
  1. 1Department of Internal Diseases, Medical University, Pleven
  2. 2Department of Internal Diseases, Medical University, Plovdiv
  3. 3Department of Internal Diseases, Medical University, Sofia, Bulgaria


Background Osteoarthritis (OA) is the most common rheumatic disease, which appears after the age of 40 years.

Patients with osteoarthritis comprise up to 43% of the general practitioners’ patients (GP)1. The treatment of this disease engage other specialists also – rheumatologists and orthopaedists. The OA prognosis concerning life longevity is good, but it is one of the most essential reasons for disability. This defines the social importance of OA2,3.

Objectives The aim of this study is to evaluate the competence of GPs in Bulgaria for the treatment of OA patients and the collaboration with the specialists – rheumatologists and orthopaedists.

Methods A questionnaire was filled in by 27 GPs, who have 29 465 patients (aged above 18) in their registers. Patients with OA present 54,11% of all registered patients. The questionnaire includes questions about pharmacological and non-pharmacological agents for OA treatment; intraarticular injection of corticosteroids and synthetic hyaluronic acid; referrals of patients to a specialists; prevalence of visits of OA patients in GP’s practices.

Results Data of the questionnaires indicates :

  1. 74,07% of GPs use most often nonsteroid anti-inflammatory drugs (NSAIDs) for control of pain in OA patients;

  2. 77,77% of GPs require body weight reduction as a basic non-pharmacological agent;

  3. 14,81% of GPs inject intraarticular corticosteroids;

  4. 3,70% of GPs inject intraarticular synthetic hyaluronic acid;

  5. 55,55% of GPs refer the OA patients to a rheumatologist and 44,45 refer them to an orthopaedist;

  1. GPs control the pain of OA patients most often with non-steroid antiinflamatory drugs.

  2. GPs refer the OA patients to specialists for intraarticular injection of drugs.

  3. In Bulgaria OA patients are dyspancerized by specialists rheumatologists. Guidelines for management of OA patients from general practitioners need to be introduced and applied.

  1. Rasker J.J.Rheumatology in general practice. Br J Rheumatol 1995, 34:494-7

  2. Lopez-Olivo MA, Suarez -Almazor ME.Developing guidlines in musculoskeletal disorders. Clin Exp Rheumatol.2007 Nov-Dec:25

  3. Dziedzic KS, Hill JC, Porcheret M, Croft PR: New models for primary care are needed for osteoarthritis. Phys Ther 2009, 89(12):1371-1378. 6 Suppl 47):28-36

Disclosure of Interest None Declared

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