Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, UK.
Rheumatology (Oxford). 2010 May;49(5):1005-12. doi: 10.1093/rheumatology/keq011. Epub 2010 Feb 26.
Delay in assessment by rheumatologists of patients with new-onset RA is an important determinant of delay in treatment initiation. The influence of ethnicity on delay in assessment has not been addressed. We studied the extent of delay in patients of South Asian origin compared with other patients and the reasons underlying this delay.
Data were collected from 272 patients with RA at the time of assessment by a rheumatologist; 43 were of South Asian origin. Delays were recorded at the level of the patient seeking advice from the general practitioner (GP), the GP referring to secondary care and the rheumatologist seeing the patient after the referral had been made. In addition, using qualitative methods, we assessed the reasons underlying delay in help-seeking behaviour in 10 patients of South Asian origin.
Patient delay was significantly longer in patients of South Asian origin than in other patients. Delays at the level of primary and secondary care were not different. Four interlinking themes influenced how rapidly early RA patients of South Asian origin consulted their GPs: symptom experience, symptom evaluation, existing ideas, and knowledge of RA and influence of friends and family.
Patient-dependent factors leading to delays in GP consultation, are the principal reason for the considerable delay in RA patients of South Asian origin being seen by rheumatologists. An understanding of the reasons underlying this delay will inform the development of interventions to reduce it in this population.
风湿科医生对新发病类风湿关节炎患者评估的延迟是治疗开始延迟的一个重要决定因素。种族对评估延迟的影响尚未得到解决。我们研究了南亚裔患者与其他患者相比延迟评估的程度，以及导致这种延迟的原因。
在风湿科医生评估时收集了 272 例类风湿关节炎患者的数据；其中 43 例为南亚裔。记录了从患者向全科医生（GP）寻求建议、GP 转介至二级保健以及转介后风湿科医生接诊的延迟时间。此外，我们使用定性方法评估了 10 例南亚裔患者寻求帮助行为延迟的原因。
南亚裔患者的患者延迟时间明显长于其他患者。初级和二级保健的延迟时间没有差异。四个相互关联的主题影响了南亚裔早期类风湿关节炎患者向他们的全科医生咨询的速度：症状体验、症状评估、现有观念以及对类风湿关节炎的认识和朋友及家人的影响。
导致全科医生就诊延迟的患者相关因素是导致南亚裔类风湿关节炎患者延迟接受风湿科医生诊治的主要原因。了解这种延迟的原因将有助于制定干预措施，减少该人群的这种延迟。
