期刊
CLINICAL RHEUMATOLOGY
卷 42, 期 10, 页码 2811-2822出版社
SPRINGER LONDON LTD
DOI: 10.1007/s10067-023-06671-z
关键词
Ankylosing spondylitis; Axial spondyloarthritis; axSpA; Inflammatory back pain; Nonradioagraphic axial spondyloarthritis; nr-axSpA
类别
This study aims to understand the diagnostic journey and barriers for US patients with nonradiographic axial spondyloarthritis (nr-axSpA). Interviews and surveys revealed that delayed diagnosis of nr-axSpA is common, with women and individuals in rural areas being more likely to experience delays. Impediments to timely diagnosis include chronic pain, episodic symptoms, other symptoms requiring medical consultation, and lack of knowledge about nr-axSpA among healthcare providers. Targeted education and research are needed to improve timely diagnosis.
Introduction/objectives Delayed diagnosis of axial spondyloarthritis (axSpA) is well documented; little is known about the diagnostic journey and impediments for US patients with nonradiographic axSpA (nr-axSpA). It is hypothesized that impediments are varied and exist at both the healthcare provider (HCP) and patient levels. This study aims to understand patient experiences and contributors to delayed nr-axSpA diagnosis in the USA. Method Interviews of adults with rheumatologist-diagnosed nr-axSpA, recruited through Spondylitis Association of America outreach and patient panels, and of rheumatologists, explored the diagnostic journey and diagnostic barriers. Emerging themes were further explored in an online patient survey. A multiple logistic regression analysis evaluated the main outcome variable, factors affecting time to nr-axSpA diagnosis. Results Interviews were conducted with 25 patients and 16 rheumatologists. Survey responses from 186 eligible patients revealed median time from symptom onset to diagnosis of nr-axSpA was 3.25 years. Delayed diagnosis was significantly more likely for women and people in rural areas. Most patients consulted >= 4 different types of HCPs before a rheumatologist and >= 2 rheumatologists before diagnosis. Impediments to timely diagnosis included insidious chronic pain; episodic symptom patterns attributed to activity; symptoms other than chronic lumbosacral back pain requiring medical consultation; and unfamiliarity with and misperceptions about nr-axSpA among HCPs, radiologists, and rheumatologists. Conclusions Delayed nr-axSpA diagnosis is common and reflects HCP knowledge gaps and frequent patient presentation with dominant nonaxial symptoms. Targeted HCP education, research into early disease patterns, and interventions sensitive to the broader spectrum of nr-axSpA manifestations are needed to improve timely diagnosis.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据