Title Alternative Hospital and clinic cooperation for the treatment of rheumatoid arthritis in Okayama Prefecture, Japan
FullText URL 126_209.pdf
Author Sada, Ken-ei| Nishida, Keiichiro| Yamanaka, Takao| Misaki, Kenta| Wakabayashi, Hiroshi| Shinoda, Junko| Takagi, Toru| Yano, Ryusuke| Nakamura, Akihiko| Nanba, Yoshifumi| Morita, Yoshitaka| Koyama, Yoshinobu| Yamamoto, Keiji| Ezawa, Kazuhiko| Ota, Yusuke| Yoshihara, Yoshiki| Miyoshi, Shinya| Natsumeda, Masamitsu| Usui, Masaaki| Yoshinaga, Yasuhiko| Hayashi, Takashi| Yamamura, Masahiro| Hashizume, Hiroyuki|
Abstract Objective: To survey the current status and problems of cooperation between clinics and hospitals in Okayama Prefecture, Japan for the treatment of rheumatoid arthritis (RA).  Methods: We distributed a questionnaire to 300 of the 983 Okayama Prefecture clinics that had either an internal medicine or orthopedic surgery department, from December 2013 to February 2014. The questionnaire covered practice pattern for RA treatment in clinics, current status of the hospital and clinic cooperation, and acceptance of the biologic therapy.  Results: One hundred clinics responded to the questionnaire. Seventy percent of the clinics reported making referrals to rheumatologists before the initiation of RA treatment, and half of the other 30% of the clinics administered methotrexate as the first-line treatment for RA by their own decision. Sixty-six clinics cooperated with flagship hospitals, conducting medical and laboratory examinations, providing prescriptions, and treating common diseases of patients. These clinics expected the cooperating rheumatologists to follow-up patients every 3 to 6 months and to make the diagnosis, make decisions regarding RA treatment changes, and perform surgery. Seventy-one percent of the clinics responded that cooperation with a hospital is possible even for patients who are administered biologics. As reasons for no cooperation with the flagship hospitals, clinics noted the lack of information about rheumatologists in the area and recent trends in the management of RA.  Conclusion: The current study reported, for the first time, the actual conditions of management of RA in clinics, as well as future problems of hospital and clinic cooperation in Okayama Prefecture.
Keywords 病診連携(hospital and clinic cooperation) 関節リウマチ(rheumatoid arthritis) 生物学的製剤(biologics) メトトレキサート(methotrexate)
Publication Title 岡山医学会雑誌
Published Date 2014-12-01
Volume volume126
Issue issue3
Start Page 209
End Page 215
ISSN 0030-1558
language 日本語
Copyright Holders Copyright (c) 2014 岡山医学会
File Version publisher
DOI 10.4044/joma.126.209
NAID 130004903246
Author Usui, Masaaki|
Published Date 1992
Publication Title 岡山医学会雑誌
Volume volume104
Issue issue3-4
Content Type Journal Article