Management Practices of Juvenile Idiopathic Arthritis among Rheumatologists in India
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 12
Abstract
Introduction: Pediatric rheumatology is a young speciality in India. There is a need to study the awareness and practice of pediatric rheumatological illnesses among practicing rheumatologists and pediatric rheumatologists in India. So a study was done to highlight this gap in health services and the need for developing pediatric rheumatology services in various parts of the country. Material and Methods: A survey in the form of a questionnaire was either emailed or sent to registered rheumatologists in the Indian Rheumatology Association in all states of India by whatsapp or email. Analysis of the survey was performed. A total of 500 professionals were contacted and despatched the survey. Results: A total of 141 responses (28.2% response rate) from all over India were obtained. 8.8% of responders were exclusively pediatric rheumatologists. The majority (62.5%) saw pediatric patients of all ages however only 14% reported feeling comfortable with making a diagnosis in children below 3 years of age. Only 16.7% of responded were comfortable with treating children younger than 3 years of age. 64% would consider 20mg as an appropriate dose of methotrexate in a 40 kg child. About 11.7% would refer pediatric patients to pediatric rheumatologists for initiation of disease modifying antirheumatic drug (DMARD) therapy, 28% if refractory to first line therapy and 19% for biologics therapy. 15% would prefer to refer young patients straightaway. Overall 61% would prefer to refer to a pediatric rheumatologist if one was accessible. Conclusion: The majority of adult rheumatologists saw small numbers of pediatric patients and seemed to be more conservative with dosing DMARDs. A majority would prefer to refer children with pediatric rheumatological illnesses to pediatric rheumatologists if accessible. The study underlines the need to highlight the speciality and develop training pathways for pediatric skilled doctors to train in this specialty so that there can be access to pediatic rheumatologists across all zones in the country.
Authors and Affiliations
Suma Balan, Mahesh Janarthanan
Keywords
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