title: Differences between rheumatologists and other internists regarding diagnosis and treatment of systemic lupus erythematosus.
abstract: OBJECTIVE
  To compare the diagnostics and treatment of SLE patients in the care of rheumatologists with patients in the care of other specialities within a geographically complete cohort.
  
  
  METHODS
  Nine different sources were used to identify SLE patients resident in Oslo between 1999 and 2008. Only SLE patients fulfilling four or more of the updated 1997 ACR criteria were included. Data were extracted from medical records. The patients were classified into three groups according to each patient's responsible doctor's speciality.
  
  
  RESULTS
  A total of 325 SLE patients were included in the study. Of these, 227 had solely been in the care of rheumatologists (rheumatology group), 34 had solely been in the care of nephrologists, haematologists or infectious disease specialists (non-rheumatology group) and 64 had been in the care of both rheumatologists and other specialists (multidisciplinary group). Even though patients in the non-rheumatology group and multidisciplinary group showed similar disease characteristics, patients in the non-rheumatology group were less often tested for aPLs (68 vs 94%; P = 0.001) and less often treated with HCQ (12 vs 78%; P < 0.001).
  
  
  CONCLUSIONS
  In contrast to rheumatologists, non-rheumatologists do not routinely test all SLE patients for aPLs, and rarely prescribe HCQ. These findings indicate that more communication between different specialists caring for SLE is needed, and highlights an area in need of agreement.
authors.affiliation: Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Pb 4950 Nydalen, 0424 Oslo, Norway. klerang@ous-hf.no
authors.forename: Karoline
authors.initials: K
authors.lastname: Lerang
authors.forename: Inge-Margrethe
authors.initials: IM
authors.lastname: Gilboe
authors.forename: Jan Tore
authors.initials: JT
authors.lastname: Gran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017152:Antibodies, Antiphospholipid / Q000097:blood; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002648:Child; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research / Q000379:methods; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007400:Interprofessional Relations; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008511:Medicine / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D009664:Norway; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012219:Rheumatology / Q000379:methods* / Q000592:standards; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid; D018501:Antirheumatic Agents; D015415:Biomarkers; D006886:Hydroxychloroquine