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Title

THE ACCESS OF PATIENTS WITH RHEUMATOID ARTHRITIS TO MULTIDISCIPLINARY TREATMENT IN BRAZIL

Background

Recent guidelines for the management of rheumatoid arthritis (RA) emphasize the importance of the use of non-pharmacological treatment in addition to the use of pharmacologic agents. The rheumatologist should be responsible for coordinating the treatment, along with a multidisciplinary team, ideally composed by a physiotherapist, psychologist and occupational therapist, among other professionals. However, the patients' access to this type of treatment in Brazil is not yet known. Thus, the objective of this study is to analyze the access to non-pharmacological treatment and identify factors associated with the multidisciplinary approach.

Materials and methods

: An anonymous web-based questionnaire through Google Forms was publicly available for 4 months in 2018. Patients reported demographic data, their diagnosis, treatments, number of rheumatologist visits per year, if they have unanswered questions and if doctor language is accessible during office visits. Data collected were exported to Microsoft Excel and statistical analysis was performed using IBM-SPSS.

Results

991 responders had a self-reported rheumatoid arthritis diagnosis, 94,7% were female and mean age was 46 (+/-11,59) years. 371 (37.4%) used at least 1 type of non-pharmacologic modality. 221 (22.3%) were doing physiotherapy, 112 (11.3%) occupational therapy and 157(15.8%) psychotherapy. Table 1 shows characteristics of patients with and without the adoption of a multidisciplinary treatment.

Conclusions

Multidisciplinary approach is recommended by guidelines, but less than half of patients are getting it. The factors associated with a greater adoption of multidisciplinary treatment can be clustered into two groups, one related to information, including patient education and appropriate doctor-patient communication, and other to resources, whether provided by the patient or by the health system.

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