Objective The primary care physician is a key element from diagnosis to management and monitoring of patients with Systemic Lupus Erythematosus (SLE). The objective of our work was to evaluate the knowledge of primary care physicians regarding SLE.

Methods Cross-sectional study spanning between February 2023 and March 2023, based on a Google Forms questionnaire distributed to junior and senior family doctors and general practitioners, via social networks. The form has 6 sections relating to SLE from diagnosis to follow-up, with an independent score for each part. Participation in this study was voluntary and responses were treated anonymously.

Results Thirty-five participants responded to the questionnaire. They were distributed as follows: family medicine residents (n=26); family doctors (n=6); general practitioners (n=3). The geographical distribution of participants was: Grand-Tunis (n=29); Sfax (n=1); Sousse (n=2); Kairouan (n=1); Mehdia (n=1); Nabeul (n=1). The average length of service in the specialty was 2.08 years [1;8]. Twenty-one participants (60%) did a rotation in internal medicine during their residency training. The approximate average number of SLE patients seen during the past year was 4.9 patients [0;40] with 11 participants not seeing any (31.4%).

The average response for the ‘when to think of SLE’ section was 3.92/6 [0;5]. The average for the ‘manifestations of SLE’ component was 6.22/7 [0;7]. As for ‘diagnosis confirmation’, the average score was 7.02/10 [0;9]. For the ‘biological markers of SLE activity’ section, the average was 1.47/4 [0;3]. The average response for the ‘immunological assessment’ section was 2.38/5 [0;4]. As for ‘SLE treatments’, the average response was 1.88/4 [0;4]. For vaccination, the average response was 1.08/2 [0/2]. 26 participants know that SLE constitutes a cardiovascular risk factor (74%).

All participants stated that they refer SLE patients to internists and not to rheumatologists. Thirty-one participants judged that the management of SLE patients would be better in specialized centers rather than in first-line structures.

Conclusions The average responses to questions regarding disease activity and vaccination were the least satisfying. This could be due to the limited participation of primary care physicians in Tunisia in the follow-up of SLE patients once the diagnosis is made. A policy of collaboration between the latter and internists must be studied in a more elaborate manner.