title: Comparison of general practitioners and rheumatologists' prescription patterns for patients with knee osteoarthritis.
abstract: BACKGROUND
  To compare the prescription modalities of general practitioners (GPs) and rheumatologists (RHs) for symptomatic knee osteoarthritis (OA) and to determine correlates with prescription of low-dose NSAIDs.
  
  
  METHODS
  This observational, prospective, national survey was carried out among a national representative sample of GPs (n = 808) and RHs (n = 134). Each physician completed a medical questionnaire for the 2 most recent patients fulfilling the ACR criteria for knee OA.
  
  
  RESULTS
  GPs and RHs included 1,570 and 251 patients, respectively. Mean pain level of the knee (on a VAS, 0-100 mm) was greater for GP patients than for RH patients (49.8 ± 16.3 vs. 46.2 ± 17.1 mm, respectively; p < 0.01). As compared with patients of RHs, those of GPs more frequently had another joint affected by OA: 71.2% vs. 63.7% (p < 0.0001) and more often had hypertension and diabetes mellitus (p < 0.05). As compared with RHs, GPs more frequently prescribed low-dose NSAIDs (p < 0.0001), oral NSAIDs (p < 0.05), and topical NSAIDs (p < 0.0001) but less frequently symptomatic slow-acting drugs for OA (p < 0.01). Moreover, GPs more frequently recommended rehabilitation (p < 0.01) and loss of weight (p < 0.0001). Logistic regression analysis revealed an association of low-dose NSAIDs prescription and prescription by GPs, prescription of topical NSAIDs, no prescription of oral NSAIDs or coxibs and no intra-articular injection of steroids.
  
  
  CONCLUSIONS
  This study identified speciality-related variability in some aspects of the management of knee OA. The clinical profile of patients with knee OA differed between GPs and RHs.
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, 75010, Paris, France. pascal.richette@lrb.aphp.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Richette
authors.forename: Pascal
authors.initials: P
authors.lastname: Hilliquin
authors.forename: Philippe
authors.initials: P
authors.lastname: Bertin
authors.forename: Paolo
authors.initials: P
authors.lastname: Carni
authors.forename: Véronique
authors.initials: V
authors.lastname: Berger
authors.forename: Marc
authors.initials: M
authors.lastname: Marty
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018771:Arthralgia / Q000188:drug therapy* / Q000517:prevention & control; D004185:Disability Evaluation; D058005:General Practitioners / Q000639:trends; D006801:Humans; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D010147:Pain Measurement / Q000379:methods / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000639:trends; D011446:Prospective Studies; D012219:Rheumatology / Q000639:trends; D011795:Surveys and Questionnaires / Q000592:standards
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal