A XXXX survey of barriers to intensive combination treatment strategies with glucocorticoids in early @entity309 .

@entity1 @entity2653 @entity309
UNASSIGNED: The objectives of the study were  to determine the relative importance of barriers related to the provision of intensive combination treatment strategies with glucocorticoids (ICTS-GCs) in early @entity309 (ERA) from the rheumatologists' perspective and to explore the relation between rheumatologists' characteristics and importance scores. A @entity2653 ( @entity2653 ) survey was administered to 66 rheumatologists in Flanders and the Brussels-Capital Region. The survey included 25 barriers, previously being discovered in a qualitative study. The survey included 25 choice sets, each of which contained a different set of four barriers. In each choice situation, respondents were asked to choose the most important barrier. The mean relative importance score (RIS) for each barrier was calculated using hierarchical Bayes modeling. The potential relation between rheumatologists' characteristics and the RIS was examined using Spearman's correlation coefficient, Mann-Whitney U test, and Kruskal-Wallis H test. The three highest ranked barriers included "contraindicated for some @entity1 (e.g., @entity1 with comorbidities, older @entity1 )," "an increased risk of side effects and related complications," and " @entity1 ' resistance" with a mean        SD RIS of 9.76        0.82, 8.50        1.17, and 7.45        1.22, respectively. Comparing the RISs based on rheumatologists' characteristics, a different ranking was found for three barriers depending on the age, university location, and/or frequency of prescribing ICTS-GCs. The dominant barriers hindering ICTS-GCs prescription from a rheumatologists' perspective are @entity1 -related barriers and barriers related to the complexity of prescribing a combination therapy including GCs. A tailored improvement intervention is needed to overcome these barriers and should focus on the familiarity of rheumatologists with ICTS-GC and @entity1 education.
