Knowledge, Attitude, and Practice Regarding Rheumatoid Arthritis Management and Associated Factors Among Primary Healthcare Providers in Public Health Facilities of Addis Ababa, Ethiopia (2025): A Cross-Sectional Study
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Date
2025
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Addis Ababa University
Abstract
Background: Rheumatoid arthritis (RA) is a known chronic and autoimmune condition that needs to be diagnosed early to be managed early to prevent lifelong disability. There is little known about RA among PCPs in Ethiopia, which may contribute for the inadequate treatment and care of RA patients. In this study, PCPs knowledge, attitude, and practice (KAP) of RA diagnosis and management were identified with the factors linked.
Objective: In this study, the initial aim was to evaluate PCPs knowledge, attitudes, and practices regarding the diagnosis and management of RA in public health facilities in Addis Ababa, Ethiopia. The other intention of the study was to identify the socio-demographic and professional factors that influence these KAP levels, to guide proper interventions for stronger RA care at the primary healthcare level.
Methods: A cross-sectional study carried out during August 1 to September 30, 2025, that involved 210 healthcare providers among fourteen public health facilities in Addis Ababa. Data was gathered using a structured and self-administered questionnaire and analyzed with SPSS version 27 to assess RA KAP and the contributing factors to these outcomes.
Results: Among 210 primary healthcare providers (female-to-male ratio 1:1.44), the majority were Internal Medicine residents (29.0%) and General Practitioners (28.1%). Overall, 50.5% demonstrated poor knowledge of RA, while only 3.8% had good knowledge. Despite this, 62.4% exhibited a favorable attitude toward RA diagnosis and management, and 88.1% reported good clinical practice. Good knowledge was significantly associated with being an Internal Medicine resident (AOR = 11.7; 95% CI: 1.8–76.2; p = 0.01) or a Family Medicine resident (AOR = 30.0; 95% CI: 1.8–1190.3; p = 0.03), seeing ≥200 patients per week (AOR = 100.9; 95% CI: 11.2–908.1; p < 0.001), and working in tertiary hospitals (AOR = 2.44; 95% CI: 2.1–65.9; p = 0.019). Favorable attitudes were predicted by being a General Practitioner (AOR = 1.75; p = 0.036), Internal Medicine resident (AOR = 4.17; p = 0.045), or Family Medicine resident (AOR = 1.35; p = 0.049); having 11–20 years (AOR = 3.32; p = 0.031); and seeing ≥200 patients per week (AOR = 44.3; p = 0.002). Good practice was associated with age 25–29 years (AOR = 4.78; p = 0.032), seeing ≥200 patients per week (AOR = 1.03; p = 0.047), and experiencing difficulty obtaining expert opinion (AOR = 7.39; p = 0.006).
Conclusion: Primary healthcare providers in Addis Ababa have good practice and a positive attitude in RA care, which shows their commitment. However, knowledge gaps remain high even though RA is included in Ethiopia’s Standard Treatment Guidelines. This can be solved by improving ongoing training, practical guidance, and access to specialist support, which can help strengthen RA management and patient outcomes.
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RA Rheumatoid Arthritis