[Diagnosis and therapeutical management offered to rheumatoid arthritis patients in Brazil--rheumatologists' answers from an assessment questionnaire].
OBJECTIVE
The aim of this study was to evaluate in relation to diagnosis and treatment for Rheumatoid Arthritis (RA) patients Brazilian population, and compare the management offered to patients who are followed up in the public and private sectors.


METHODS
An electronic questionnaire was sent to 650 rheumatologists, members of the Brazilian Rheumatology Society (SBR) and who were attending adult RA patients in the public and/or private sector, who had a contact e-mail address available in the SBR register and agreed to take part in the survey.


RESULTS
The rheumatologists estimated that 51.7% of the patients had had their disease diagnosed and of these, 56.1% were undergoing treatment. It was also estimated that 53.9% of the RA patients that was under treatment were being followed up by rheumatologists. The mean time interval estimated by the rheumatologists, between the appearance of the first symptoms of RA and the diagnosis made by a doctor, was greater among the patients who sought attendance in public services (1.8 years). There was no difference in clinical and radiographic assessment measures between the two types of service, with the exception of the application of HAQ, which was used more in public services. The principal drug association reported in both types of services was methotrexate and chloroquine. The rate of usage of associations between biological agents and methotrexate ranged from 6 to 8%. The main treatment-related difficulties were: access to the health system (public services) and cost of medication (private services).


CONCLUSIONS
Approximately 50% of RA patients are being diagnosed and half of these are under treatment. There was no great difference in attendance within the public and private systems for these patients, whereas the main difficulty for the public system was access to attendance, for the private system it was the cost of the medication.
Ferraz
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MB
UNIFESP - Docente e pesquisadora do Centro Paulista de Economia da Saúde - CPES - UNIFESP. marcos.ferraz@cpes.org.br
de Soarez
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PC
Riera
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Ciconelli
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RM
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000628:therapy*; D001938:Brazil; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D012219:Rheumatology; D011795:Surveys and Questionnaires