KNOWLEDGE GAPS AND REFERRAL PRACTICES REGARDING BEHÇET'S DISEASE AMONG HEALTHCARE PROVIDERS IN JORDAN: A CROSS-SECTIONAL STUDY

Abstract

Background: Behçet's disease is a multisystem inflammatory disease that affects many body systems. It is particularly prevalent among populations along the Silk Road. Symptoms of Behçet's disease typically manifest as mucosal or skin problems before systemic or disseminated symptoms appear. Early diagnosis of these symptoms aims to prevent irreversible damage to the body. However, symptoms often go unrecognized by frontline healthcare providers, leading to delayed diagnosis.

Objectives: This study aimed to assess the knowledge of healthcare providers in Jordan regarding Behçet's disease, identify the factors influencing their referral of patients with the disease for medical care, and examine the relationship between knowledge and practice by developing a statistical model.

Methods: A cross-sectional study was conducted in Jordan from September to November 2025. An online questionnaire was distributed to a convenience sample of approximately 600 healthcare professionals (physicians and dentists). We received 365 valid responses (response rate: 60.8%). Data was analyzed using ANOVA, multiple regression, and advanced techniques including path and cluster analysis.

Results: The mean knowledge score was 7.32 out of 11 (SD = 1.85). Statistically significant differences in scores were found based on specialty. Internal medicine specialists scored the highest, while general dentists and general practitioners scored the lowest. Referral rates were low, with 76.2% of participants having never referred to a suspected patient. Path analysis revealed that knowledge mediated 33.8% of the specialty's influence on referral behavior. Cluster analysis identified a high-risk group of uninformed practitioners (23.3%), primarily dentists and general practitioners, with both low knowledge and low referra rates.

Conclusion: A significant knowledge gap exists among primary healthcare practitioners (dentists and GPs) in Jordan. Knowledge is a crucial factor in timely patient referral. This group should be targeted with educational programs to improve early diagnosis and patient outcomes. This study assessed healthcare providers' awareness, not public awareness.