Early referral to the rheumatologist for early arthritis patients: evidence for suboptimal care. Results from the ESPOIR cohort

Rheumatology
Bruno FautrelFrancis Guillemin

Abstract

To assess the time to access a rheumatologist (TTAR) by early arthritis (EA) patients participating in a nationwide incidental cohort (ESPOIR) and compare it with European League Against Rheumatism (EULAR) recommendations, which recommends rapid referral, ideally within 6 weeks, to a rheumatologist for patients presenting with EA. Eight hundred and thirteen patients with EA were included in the cohort between 2002 and 2005. The inclusion criteria were 18-70 years old, two or more swollen joints, symptom duration from 6 weeks to 6 months and possible RA diagnosis. TTAR was defined as the time between the first synovitis and first visit to a rheumatologist. TTAR and satisfaction of the EULAR guidelines were investigated by multiple linear and logistic regressions. Mean TTAR was 76 days; only 46.2% of patients were seen by a rheumatologist within the EULAR-recommended time frame. Patients' patterns of accessing medical care substantially affected access to specialized care: mean TTAR was 58 days for patients who directly scheduled an appointment with the rheumatologist and 78 days for those referred by their general practitioner (P < 0.0007). Only 57.2 and 44.5%, respectively, were able to consult a rheumatologist within 6 weeks. ...Continue Reading

References

May 1, 1992·Annals of the Rheumatic Diseases·J P Leigh, J F Fries
Jun 1, 1992·Current Opinion in Rheumatology·R S PanushE D Rosenstein
Jun 1, 1990·Annals of the Rheumatic Diseases·P A ReillyA J Silman
Feb 1, 1995·British Journal of Rheumatology·A Bradlow
Jan 1, 1994·Scandinavian Journal of Rheumatology. Supplement·T Pincus
Jan 10, 1994·Archives of Internal Medicine·R C Bone
Dec 1, 1995·Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association·L F Callahan, T Pincus
Apr 15, 1996·Annals of Internal Medicine·M E Weinblatt
Mar 18, 2000·Scandinavian Journal of Rheumatology·A G KvalvikD P Symmons
Sep 5, 2002·Arthritis and Rheumatism·Nicola J GoodsonDeborah P M Symmons
Jun 10, 2003·Arthritis and Rheumatism·Frederick WolfeHyon K Choi
Jul 9, 2003·Arthritis and Rheumatism·Maarten Boers
Sep 18, 2003·Arthritis and Rheumatism·Gregorio Navarro-CanoAgustín Escalante
Oct 14, 2004·Annals of the Rheumatic Diseases·B N Cronstein
Sep 6, 2005·Arthritis and Rheumatism·Daniel AletahaJosef S Smolen
Jun 14, 2006·Annals of the Rheumatic Diseases·G H EsselensR Westhovens
Dec 13, 2006·Annals of the Rheumatic Diseases·Lennart T H JacobssonPierre Geborek
Mar 14, 2007·Best Practice & Research. Clinical Rheumatology·Bernard Combe
Jan 26, 2008·BMJ : British Medical Journal·Kimme L Hyrich

❮ Previous
Next ❯

Citations

Sep 27, 2013·BMC Musculoskeletal Disorders·Pedro A LairesJoão Eurico Fonseca
Dec 8, 2014·Best Practice & Research. Clinical Rheumatology·Francis GuilleminLinda C Li
Aug 7, 2010·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Philip C Robinson, William J Taylor
Apr 10, 2013·Rheumatology International·José Andrés Román IvorraLoreto Carmona
Dec 6, 2011·Best Practice & Research. Clinical Rheumatology·Bruno FautrelAnnelies Boonen
Aug 27, 2014·Arthritis Care & Research·Lisa L CumminsLynden J Roberts
Sep 18, 2013·European Journal of Internal Medicine·Oscar EpisEnrico Tirri
Sep 23, 2014·Joint, Bone, Spine : Revue Du Rhumatisme·Bernard Combe, Nathalie Rincheval
Jul 28, 2016·Joint, Bone, Spine : Revue Du Rhumatisme·Vanina Masson BeharLaure Gossec
Jul 5, 2011·The Journal of Rheumatology·Joanne E Homik
Apr 3, 2016·The Journal of Rheumatology·Rudolf PuchnerKlaus Machold
Feb 23, 2011·Rheumatology International·C JackS Bernatsky
Sep 2, 2014·Internal Medicine·Yuko Kaneko, Tsutomu Takeuchi
Sep 28, 2012·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Ashley DelaurierDebbie Ehrmann Feldman
Dec 24, 2018·BMC Health Services Research·James Greenwood-LeeDeborah A Marshall
Aug 7, 2020·Joint, Bone, Spine : Revue Du Rhumatisme·Joanna KedraBruno Fautrel

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.