Strategies needed to increase awareness of Dupuytren’s disease

DiBenedetti DB. Hand. doi:10.1007/s11552-010-9306-4.

Results of a population-based study indicate that strategies are needed to increase physician awareness of Dupuytren’s disease symptoms and treatment options.

For phase 1 of this study, 23,103 people from an Internet-based research panel representative of the U.S. population were screened for current disease symptoms, diagnoses and/or treatment experience indicating Dupuytren’s disease. Dana Britt DiBenedetti, PhD, and colleagues used these data to estimate disease prevalence in the U.S. population.

Based on self-reported physician diagnosis and/or surgical treatment, the prevalence of Dupuytren’s disease is 1%. The prevalence rises to 7.3% when the estimate includes self-reported symptoms of ropelike growth or hard bumps on the hand. In the general U.S. population, the annual incidence proportion is about three cases per 10,000 adults.

In phase 2, a subsample of 326 patients who met the eligibility criteria for Dupuytren’s disease completed a more detailed survey, which collected information on symptom severity, timing and type of first symptoms noticed, treatment seeking patterns, diagnoses and brief medical and family histories.

The results showed that more than two thirds of Dupuytren’s patients reported having a hard bump on one or both hands, and one third reported that their symptoms interfered with everyday activities.

“Yet nearly 40% of those reporting a diagnosis, treatment, or a hand symptom indicated they had never sought medical treatment,” the authors wrote in their study abstract.

Most patients who sought treatment for hand symptoms saw a primary care physician first. Those who sought treatment did not do so immediately. The average time from symptom onset to seeing a doctor was 23.1 months. Of those patients who sought treatment, only 9% of patients were diagnosed with Dupuytren’s disease; 48% were advised to “wait and see” or received no treatment.