More than 30% of PCPs fail to follow physical activity guidance for RA patients
ATLANTA — Nearly one-third of primary care providers who treat patients with arthritis failed to follow Exercise Is Medicine guidance for physical activity, according to data presented at ACR/ARP 2019.
“While many adults with arthritis fear that physical activity will cause pain, routine physical activity can reduce pain levels comparable to NSAIDs,” Dana Guglielmo, MPH, Oak Ridge Institute for Science and Education (ORISE) epidemiology fellow assigned to CDC’s Arthritis Program, told Healio Rheumatology in an interview. “Adults with arthritis need and want their health care provider to counsel them on how to become physically active.”
Guglielmo and colleagues assessed cross-sectional data from the 2018 DocStyles survey to determine the extent to which PCPs who treat rheumatologic diseases were following Exercise Is Medicine (EIM) guidance. The analysis included 1,389 providers, ranging from family practitioners to internists and OB/GYNs who were asked if they follow, partially follow, or do not follow EIM guidance when seeing their patients with arthritis.
Results showed that 39.7% (95% CI, 37.2-42.3) of providers follow guidance, while 27.4% (95% CI, 25-29.7) partially follow guidance, and 32.9% (95% CI, 30.4-35.4) do not follow guidance.
Older providers were more likely to follow EIM guidance than younger providers, with those aged 21 to 39 years reporting a “follow” rate of 32.8%, compared with 47.3% for those older than 50 years.
A similar phenomenon was reported for the number of years practicing medicine, with 32.4% of those who practiced for less than 10 years following guidance and 51% of those who had practiced for more than 30 years doing so.
Physicians who had fewer than 75 patients followed guidance at a rate of 35.3%, compared with 46.4% for those with more than 125 patients. Those who saw one to nine patients with arthritis per week were less likely than those who saw more than 20 patients with arthritis per week to follow EIM guidance, 30.2% vs. 56.4%.
OB/GYNs were the least likely practitioners to follow EIM guidance, with 49.5% (95% CI, 42.2-56.7) reporting “do not follow.” Those working in inpatient settings reported the second highest rates of not following EIM guidance, at 41.3% (95% CI, 37.4-45.2). In addition, physicians living in the south also were unlikely to follow EIM guidance (37.7%; 95% CI, 33.4-42).
“While the poster focuses on primary care providers, the principles are applicable to rheumatology providers,” Guglielmo said. “We hope these findings will encourage rheumatology providers to engage in these important conversations about physical activity with their patients and refer them to evidence-based physical activity programs.” – by Rob Volansky
Guglielmo D. Abstract #275. Exercise is medicine in primary care practice: provider characteristics and physical activity counseling for patients with arthritis, DocStyles 2018. Presented at: American College of Rheumatology/Association of Rheumatology Professionals Annual Meeting; Nov. 9-13, 2019; Atlanta.
Disclosure: Guglielmo reports no relevant financial disclosures.