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Prescribing for Children With Rheumatic Disease: Perceived Treatment Approaches Between Pediatric and Adult Rheumatologists.

Publication ,  Journal Article
van Mater, H; Balevic, SJ; Freed, GL; Clark, SJ
Published in: Arthritis Care Res (Hoboken)
February 2018

OBJECTIVE: To compare practice patterns and prescribing differences for juvenile idiopathic arthritis (JIA) between adult rheumatologists (ARs) and pediatric rheumatologists (PRs), the perceived educational needs, and factors that enhance or impede co-management. METHODS: Two parallel, cross-sectional surveys focusing on JIA were administered in 2009 to a random sample of 193 PRs and 500 ARs using the American College of Rheumatology membership file. Bivariate analysis was conducted for common items. RESULTS: The response rate was 62.1% for ARs (n = 306) and 72.3% for PRs (n = 138). Only 23% of responding ARs (n = 69) reported caring for children with JIA. Of these, 94% strongly agreed/agreed feeling comfortable diagnosing JIA; however, only 76% felt comfortable treating JIA. Clinical vignettes highlighted several prescribing differences. Forty-eight percent of ARs and 31% of PRs felt medications to treat JIA did not have clear dosing guidelines. Though PRs initiated disease-modifying antirheumatic drugs and biologic agents earlier, treatments were similar after 3 months. To enhance co-management, 74% of pediatric respondents endorsed shared medical records. CONCLUSION: Nearly one-quarter of surveyed ARs care for children with JIA, with most limiting their practice to older children. There was more discomfort in treating JIA than diagnosing it, and there were significant prescribing differences. Both provider types identified the need for better dosing and treatment resources. Updated management guidelines along with exposure to pediatric rheumatology in fellowship could reduce treatment differences and enhance the care of children with JIA. Shared medical records and improvement in reimbursement may optimize co-management.

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Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

February 2018

Volume

70

Issue

2

Start / End Page

268 / 274

Location

United States

Related Subject Headings

  • Risk Factors
  • Rheumatologists
  • Practice Patterns, Physicians'
  • Humans
  • Health Knowledge, Attitudes, Practice
  • Health Care Surveys
  • Drug Prescriptions
  • Drug Dosage Calculations
  • Cross-Sectional Studies
  • Clinical Competence
 

Citation

APA
Chicago
ICMJE
MLA
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van Mater, H., Balevic, S. J., Freed, G. L., & Clark, S. J. (2018). Prescribing for Children With Rheumatic Disease: Perceived Treatment Approaches Between Pediatric and Adult Rheumatologists. Arthritis Care Res (Hoboken), 70(2), 268–274. https://doi.org/10.1002/acr.23273
Mater, Heather van, Stephen J. Balevic, Gary L. Freed, and Sarah J. Clark. “Prescribing for Children With Rheumatic Disease: Perceived Treatment Approaches Between Pediatric and Adult Rheumatologists.Arthritis Care Res (Hoboken) 70, no. 2 (February 2018): 268–74. https://doi.org/10.1002/acr.23273.
van Mater H, Balevic SJ, Freed GL, Clark SJ. Prescribing for Children With Rheumatic Disease: Perceived Treatment Approaches Between Pediatric and Adult Rheumatologists. Arthritis Care Res (Hoboken). 2018 Feb;70(2):268–74.
van Mater, Heather, et al. “Prescribing for Children With Rheumatic Disease: Perceived Treatment Approaches Between Pediatric and Adult Rheumatologists.Arthritis Care Res (Hoboken), vol. 70, no. 2, Feb. 2018, pp. 268–74. Pubmed, doi:10.1002/acr.23273.
van Mater H, Balevic SJ, Freed GL, Clark SJ. Prescribing for Children With Rheumatic Disease: Perceived Treatment Approaches Between Pediatric and Adult Rheumatologists. Arthritis Care Res (Hoboken). 2018 Feb;70(2):268–274.
Journal cover image

Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

February 2018

Volume

70

Issue

2

Start / End Page

268 / 274

Location

United States

Related Subject Headings

  • Risk Factors
  • Rheumatologists
  • Practice Patterns, Physicians'
  • Humans
  • Health Knowledge, Attitudes, Practice
  • Health Care Surveys
  • Drug Prescriptions
  • Drug Dosage Calculations
  • Cross-Sectional Studies
  • Clinical Competence