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ANALYSIS OF THE DEGREE OF TECHNICAL KNOWLEDGE IN OSTEOMYOARTICULAR DISEASES BY SPECIALIST PHYSICIANS AND ITS RELATIONSHIP TO THE REASONS FOR REFERRING PATIENTS TO THE RHEUMATOLOGY SERVICE AT A CENTER OF MEDICAL SPECIALTIES IN BELEM, PARA, BRAZIL
Although the high prevalence of osteomyoarticular complaints, there is a persistence of technical difficulties related to the early diagnosis and treatment of them. The aims of the study were identify the degree of technical knowledge in osteomyoarticular diseases by doctors and its relationship to the reasons for referring patients to the Rheumatology service.
Materials and methods
The study was transversal and analytical. A questionnaire was applied to specialist doctors and resident physicians working at a medical specialty center in 2018. The questionnaire listed five clinical cases, which were evaluated by a rheumatologist, in order to validate the issues applied. Study variables included: knowledge of the interviewed about diagnosis, conduct and management of osteomyoarticular diseases (osteoarthritis, fibromyalgia, primary osteoporosis, Gout disease and rheumatism of soft parts), and the main reasons for internal referrals to rheumatology department.
The questionnaire was applied to 93 interviewees, of whom only 13 (14%) correctly answered all five questions. The highest proportion of correct answers (27.9%) was observed for 3 of 5 questions answered (26 professionals). The interviewees' knowledge about the adequate management of osteomyoarticular diseases with a greater proportion (79.6%) was related to the “specific diagnosis, conduct and follow-up of Gout disease”; followed by the perception about “targeted treatment of the primary osteoporosis” (78.5%). About the main reasons to refer patients, the highest proportion was due to the "complexity of the cases involving osteomyoarticular complaints" (66.7%); followed by the "level of knowledge about diagnosis, clinical examination and treatment of osteomyoarticular diseases"(52.7%). The analysis of the relationship between referral reasons and correct answers, showed a greater proportion of right answers regarding the clinical case of fibromyalgia for the reason of "low interest to follow-up on cases of osteomyoarticular diseases". A statistically significant difference (p=0.0066) was observed in the answers to question about Gout disease. As justification for referrals, those interviewed claimed the "degree of complexity of osteomyoarticular complaints". There was also a statistically significant difference (p=0.0489) in the correct results for the clinical case of primary osteoporosis (85.5%), where the main reason for referrals was the "incipient level of knowledge on diagnosis, clinical examination and the treatment of the main osteomyoarticular diseases".
Therefore, doctors need to improve their technical knowledge about the osteomyoarticular complaints, in order to conduct the patient correctly, reducing the number ofdiseases of low complexity referred to the rheumatologist. In addition, it can reduce the patient's waiting time for a consultation in a secondary care service.
CAMILLA CRISTINA SILVA DOS SANTOS, BIANCA DOS SANTOS MELO, DILMA COSTA OLIVEIRA NEVES, FABÍOLA BRASIL BARBOSA RODRIGUES