The timely dissemination of new medical information is a complex and often faulty process. We surveyed primary care physicians to determine their knowledge and use of disease-modifying antirheumatic agents for the treatment of rheumatoid arthritis. Only 26.2% of patients hospitalized for rheumatoid arthritis had been treated with disease-modifying antirheumatic agents in the past, and 13.9% were presently receiving them. When responding to a clinical vignette on rheumatoid arthritis, only 12% (10/84) of practitioners would implement therapy with disease-modifying antirheumatic agents, while the majority would refer the patient to a rheumatologist. Experience with similar patients was clearly the factor that led to initiation of therapy. While 73% of practitioners were aware of the value of disease-modifying antirheumatic agents, only 14% prescribed them in the last year. These findings suggest that dissemination of information concerning disease-modifying antirheumatic agents has been successful, but the problems inherent in their use result in referral rather than initiation of therapy.
Stross JK. Relationships Between Knowledge and Experience in the Use of Disease-Modifying Antirheumatic AgentsA Study of Primary Care Practitioners. JAMA. 1989;262(19):2721-2723. doi:10.1001/jama.1989.03430190105040