title: Survey of Thai Physicians Regarding Recognition and Management of Inflammatory Back Pain and Spondyloarthritis.
abstract: OBJECTIVE
  To assess recognition and management of inflammatory back pain (IBP) and spondyloarthritis (SpA) among non-rheumatologists (NRs) and rheumatologists in Thailand.
  
  
  METHODS
  A cross-sectional survey was conducted among physicians in Thailand A questionnaire designed to evaluate knowledge regarding IBP and SpA was sent to 1,336 NRs. A different questionnaire regarding SpA management in practice was sent to 112 rheumatologists.
  
  
  RESULTS
  Of 1,448 questionnaires distributed, 367 (25.3%) questionnaires were returned (NRs: 321 [24.0%] and included rheumatologists, 46 [41.1%]). Among NRs, 26.6%, 20.9%, and 9.4% recognized all features of IBP according to Calin, Assessment of SpondyloArthritis International Society, and Berlin criteria, respectively. In the presence of typical features of ankylosing spondylitis, 57.8% of NRs made the correct diagnosis. Regarding related clinical skills and involvement, 43.8%, 53.6%, and 37.3% of NRs lacked confidence in distinguishing IBP from mechanical back pain, performing musculoskeletal examination, and interpretation of plain radiography, respectively. Expensive biologic agents (31.2%) and advanced disease stage at diagnosis (27.1%) were the main problems reported by rheumatologists.
  
  
  CONCLUSIONS
  Problems in diagnosis and management of SpA patients among NRs in Thailand included lack of knowledge and lack of associated clinical skills. Issues reported by rheumatologists centered on case management limitations. In order to improve overall quality of care for SpA patients, focused strategies should be implemented for both NRs and rheumatologists that consider the needs of patients, clinicians, and policy makers.
authors.forename: Mintra
authors.initials: M
authors.lastname: Tangrungruengkit
authors.forename: Varalak
authors.initials: V
authors.lastname: Srinonprasert
authors.forename: Praveena
authors.initials: P
authors.lastname: Chiowchanwisawakit
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000628:therapy; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D019468:Disease Management; D015796:HLA-B27 Antigen / Q000235:genetics; D006801:Humans; D007388:Internal Medicine; D008279:Magnetic Resonance Imaging; D008487:Medical History Taking; D009985:Orthopedics; D010808:Physical Examination; D026741:Physical Therapy Modalities; D010810:Physical and Rehabilitation Medicine; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011859:Radiography; D012219:Rheumatology; D013131:Spine / Q000000981:diagnostic imaging* / Q000473:pathology; D025241:Spondylarthritis / Q000175:diagnosis / Q000628:therapy; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000628:therapy; D011795:Surveys and Questionnaires; D013785:Thailand
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; D002097:C-Reactive Protein