Patients with rheumatoid arthritis (RA) wait almost 7 months from time of symptom onset for a rheumatology appointment in the United Kingdom, according to data published in BMJ Open.
The study recruited newly presenting adults with either RA or unclassified arthritis attending rheumatology clinics in the United Kingdom. Data were collected on the length of time between symptom onset and first seeing a general practitioner ([GP] patient delay); between first seeing a GP and being referred to a rheumatologist (GP delay); and being seen by a rheumatologist following referral (hospital delay).
Among the 822 participants, the median time between symptom onset and seeing a rheumatologist was 27.2 weeks. Only 20 per cent of patients were seen within 3 months of symptom onset.
The median patient delay was 5.4 weeks (interquartile range [IQR], 1.4-26.3 weeks). Those with a palindromic or insidious symptom onset delayed for longer than those with a non-palindromic or acute onset.
The median GP delay was 6.9 weeks (IQR, 2.3-20.3 weeks), the largest contributor to overall delay. Patients made a mean of 4 GP visits before being referred. The median hospital delay was 4.7 weeks (IQR, 2.9-7.5 weeks).
The authors say: “While delays in primary care are the largest contributor to overall delay, patient delay and hospital delay represent important components.”
They say complex multi-faceted interventions to promote rapid help seeking and to facilitate prompt onward referral from primary care should be developed.
