EULAR 2014: Shorten Delay for Access to Rheumatologic Patient Care

Many studies have found that patients tend to take a wait-and-see approach and think their symptoms will just go away.

Having heard or read that it’s important to act quickly is one of the least common reasons patients see a doctor, Dr. Raza said. “People aren’t aware of rheumatoid arthritis; they aren’t aware of what their symptoms might mean.”

Dr. Fautrel

Patients’ poor evaluation of their own symptoms is probably the factor that can be most manipulated in order to prompt patients to seek help more quickly, he said. One potential solution would be a public health campaign regarding inflammatory arthritis, but there are significant challenges associated with that. It’s not as simple as telling patients to visit the doctor for joint pain; given how common musculoskeletal symptoms are that could inundate GPs’ offices, he said. Deciding what to tell patients to look for requires more research to identify the constellation of symptoms with the best ability to identify those patients with, or at risk of, RA and to separate them from those with other less urgent musculo­skeletal conditions, Dr. Raza said.

“Getting patients with new onset RA to consult quickly is a key challenge that we must rise to,” Dr. Raza said. “A public health campaign may well help, but its content should be informed by evidence—what set of symptoms are we going to tell people that they should be looking out for?—and its impact should be formally assessed in the context of carefully designed pilots.”

Beyond broad public awareness campaigns—which might be of questionable value—there are specific opportunities to help patients assess their own symptoms better. Before people actually see a doctor, research has shown they often visit the pharmacy to get over-the-counter drugs and research their symptoms on the Web. Therefore, Dr. Raza said, easy availability of helpful information at the pharmacy might be a useful step, along with sharpening the delivery of information on commonly visited websites.

Thomas R. Collins is a freelance medical writer based in Florida.

Reference

1. Villeneuve E, Nam J, Bell M, et al. A systematic literature review of strategies promoting early referral and reducing delays in the diagnosis and management of inflammatory arthritis. Ann Rheum Dis. 2013 Jan;72(1):13–22.