NEWS

Research reveals need for increased referrals in Dupuytren’s contracture - December 2011

A Pfizer Limited survey of 700 GPs from across six European countries reveals that 41% of patients with Dupuytren’s contracture are not being promptly referred to a specialist, visiting their GP/doctors almost three times (2.8) before being referred. Earlier medical intervention and treatment of this progressive and debilitating condition can prevent permanent damage to the hand and reduce the impact of healthcare resources of multiple visits to a healthcare professional.

A low awareness of the full range of treatment options with which to manage Dupuytren’s contracture may be contributing to referral delays. 41% of GPs are discouraged from referring if patients express a fear of surgery, with 36% not referring because they feel their patients may not be fit for surgery or anaesthesia1. Despite non-surgical options being available, over half of the GPs (61%) believe that surgery for Dupuytren’s contracture is the only option.

Commenting on the survey findings, Dr Peter Finigan, General Practitioner (GP), Minor Surgery Practitioner and Director of The Stamford Clinic, Manchester, UK, stressed the important role GPs/doctors have in improving the lives of patients living with contracture: “As GPs/doctors, we are the gatekeepers in terms of diagnosing Dupuytren’s contracture, facilitating patient access to specialist intervention and care. But we can do more: there is a broader armoury with which to treat contracture with surgical and non-surgical options. We need to fully inform our patients of their options on their first visit, to help them to regain their quality of life.”

Dupuytren’s disease affects between 3 to 13% of people in Europe, and an estimated 25% of these will find that their condition progresses to Dupuytren’s contracture. In Europe, GPs state that they see on average 12 patients with contracture each year and are instrumental in its primary management. More than half (51%) of patients return to their GP after their condition has been treated, and 42% of these visit for further help or advice. Dupuytren’s contracture is a chronic condition that has psychological, social and physical implications due to the progressive loss of hand function, caused by the permanent bending of the finger or fingers into the palm. The mainstay of treatment for Dupuytren’s contracture is surgery; in addition, recent advances in treatment options are available that can help minimise the impact of the condition on hand function. XIAPEX, collagenase clostridium histolyticum (CCH), the first pharmaceutical treatment indicated for Dupuytren’s contracture in adult patients with a palpable cord, was made available in Europe earlier this year.

Commenting on the survey results, Dr. Jörg Witthaut, Consultant Hand Surgeon from Schön Klinik, Vogtareuth, Germany, said: “The successful management of Dupuytren’s contracture lies predominately in ensuring patients are fully informed of their treatment options – whether these are conventional surgical approaches or non-surgical interventions – but also referred to a specialist at an earlier stage. The optimal care pathway for patients living with contracture is to diagnose early and offer guidance on all treatment options so that patients can make fully informed decisions. GPs and specialists working in partnership may lead to better results for patients and a reduction in the risk of permanent damage to the hand.”

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