Delays in assessment of patients with rheumatoid arthritis: variations across Europe
Delays in assessment of patients with rheumatoid arthritis: variations across Europe
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DOI：
10.1136/ard.2011.151902
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发表时间：
2011-10-01
影响因子：
27.4
通讯作者：
Buckley, Christopher D.
中科院分区：
文献类型：
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作者：
Raza, Karim;Stack, Rebecca;Buckley, Christopher D.
目的发病后3个月是类风湿关节炎(RA)治疗的重要窗口。方法从10个中心(柏林、伯明翰、伊拉克利安、隆德、布拉格、斯德哥尔摩、乌梅亚、维也纳、华沙和苏黎世)收集以下延迟程度的数据：(1)从RA症状出现到请求看医护人员(HCP)；(2)从请求看HCP到该HCP评估；(3)从HCP最初评估到转诊到风湿科医生；(4)从转诊到风湿科医生到由该风湿科医生评估。10个中心从出现症状到风湿科医生评估的中位延迟时间为24周，患者在症状出现后12周内就诊的百分比从8%到42%不等。结论本研究强调了患者、专业人员和卫生系统对欧洲类风湿关节炎患者治疗延误的贡献。虽然一些中心在尽量减少某些类型的延误方面具有优势，但所有中心都需要进行干预，以确保患者得到及时的治疗。
Objective The first 3 months after symptom onset represent an important therapeutic window for rheumatoid arthritis (RA). This study investigates the extent and causes of delay in assessment of patients with RA in eight European countries.Method Data on the following levels of delay were collected from 10 centres (Berlin, Birmingham, Heraklion, Lund, Prague, Stockholm, Umea, Vienna, Warsaw and Zurich): (1) from onset of RA symptoms to request to see healthcare professional (HCP); (2) from request to see HCP to assessment by that HCP; (3) from initial assessment by HCP to referral to rheumatologist; and (4) from referral to rheumatologist to assessment by that rheumatologist.Results Data were collected from 482 patients with RA. The median delay across the 10 centres from symptom onset to assessment by the rheumatologist was 24 weeks, with the percentage of patients seen within 12 weeks of symptom onset ranging from 8% to 42%. There were important differences in the levels underlying the total delays at individual centres.Conclusions This research highlights the contribution of patients, professionals and health systems to treatment delay for patients with RA in Europe. Although some centres have strengths in minimising certain types of delay, interventions are required in all centres to ensure timely treatment for patients.