GPs' patterns of clinical assessment when faced with a patient suspected for spondyloarthritis: a prospective educational intervention study

Timely recognition and referral of patients with spondyloarthritis (SpA) is challenging due to the frequent unawareness of the clinical picture. To identify clinical assessment patterns of GPs and GP-residents when facing a patient suspected of having SpA, and to determine which components of clinical assessment were most prevalent prior to referral to the rheumatologist and whether targeted education could positively influence pattern recognition. Prospective multicentre educational intervention study in primary care practices in the Netherlands. GPs and GP-residents were visited in two rounds by standardised patients (SPs) simulating axial or peripheral SpA (dactylitis). Between these rounds, an educational intervention regarding SpA took place for part of the participants. SPs completed a case-specific checklist inquiring about disease-related items and items on physical examination. Sixty-eight participants (30 GPs and 38 GP-residents) were included and 19 (28%) received the educational intervention. In round 1, about half of the participants asked at least one question to differentiate between an inflammatory or mechanical origin of the back pain or peripheral complaint; on average,