Objectives We aimed to assess the views of general practitioners (GPs) and rheumatologists in Austria on how to optimize their cooperation in handling rheumatic patients.
Methods A questionnaire covering aspects of collaboration between GPs and rheumatologists, was sent to all 4016 GPs and 180 internal rheumatologists in Austria. Topics covered were (i) examinations and interventions to be performed by GPs before referral, (ii) the spectrum of diseases to be referred, and (iii) the role of GPs in prescribing drugs and follow-up of patients.
Results 1229 GPs and 110 rheumatologists responded to the questionnaire.
In cases of suspected arthritis, 99% of the GPs and 92% of the rheumatologists recommended laboratory tests and 92% and 70%, respectively required X-rays of affected joints before referral. Beyond rheumatoid arthritis and spondyloarthritis, psoriatic arthritis and connective tissue disease were seen unanimously as indications for presentation to a rheumatologist in any case. Only 22% of rheumatologists felt responsible for treatment of hand osteoarthritis and fibromyalgia.
Some 80% of GPs and 85% of rheumatologists agreed that treatment with synthetic or biological disease modifying drugs should be initiated by a specialist. Subsequent drug prescription and administration by GPs was supported by a majority of GPs and rheumatologists, with concomitant rheumatologist follow-up every three to six months.
In case of disease flare 87% of the GPs and 50% of the rheumatologists recommended the GP to be seen first, in case of drug toxicity, 77% and 48% respectively.
Conclusions The results of the survey show a substantial need to clearly define shared roles between rheumatologists and GPs in care of patients with rheumatic diseases.
Disclosure of Interest None declared
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