A womb with rheum: providers' knowledge and educational needs in caring for women with rheumatic diseases

Patients with rheumatic diseases have unique reproductive health needs. Recent guidelines have been established by various soceities on this topic. However, the education received by women's health providers pertaining to the recognition and management of common rheumatic diseases in patients of childbearing age is not well-defined. This study aims to assess knowledge gaps, specify aspects of care with greatest uncertainty, and assess current resources used by women's health providers in the management of their patients with rheumatic disease.

An electronic survey was distributed nationally to physicians and allied health professionals who care for reproductive age women. The survey scored participants on their correct responses and confidence ratings in three sections: (1) patients presenting with a new rheumatic disease, (2) contraception in those with a known rheumatic diagnosis, and (3) preconception/antepartum rheumatology medication management. Participants were also asked about resource utilization. Survey questions and scenarios were based on American College of Obstetrics and Gynecology Committee Opinions and the American College of Rheumatology Guidelines for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Data were captured using RedCap© and analyzed using descriptive statistics.

The survey was completed by 200 participants with majority being academic obstetricians and gynecologists. Respondents scored the lowest in recognizing new rheumatic disease presentations in peri-and post-partum periods (28.7%, 95% CI: 25.9-31.6%). Contraception counseling was the area of highest accuracy (57.5%, 95% CI: 54.2-60.8%) and confidence (44.6%, 95% CI: 41.7-47.5%), although areas for contraceptive knowledge expansion exist. Approximately 70% of respondents identified online resources as their main resource used in clinical practice and would prefer more information to be provided as a website, published guidelines, or Smartphone application.

Women's health providers lack educational opportunities to improve knowledge and confidence in managing reproductive-aged patients with rheumatic disease. Recognizing new disease presentations and antepartum medication management were identified as topics with the largest knowledge gaps. Collaborative resources are needed to fill educational needs.