Clemente Daniel, Hernández-García César, Abásolo Lydia, Villaverde Virginia, Lajas Cristina, Loza Estíbaliz, López-González Ruth, Vadillo Cristina, Fernández-Gutiérrez Benjamín, Morado Inmaculada, Angel Jover Juan
Servicio de Reumatología. Hospital Clínico San Carlos. Madrid. España.
Reumatol Clin. 2007 Nov;3(6):245-50. doi: 10.1016/S1699-258X(07)73698-7. Epub 2008 Nov 13.
To analyze changes in the lag time to first disease modifying antirheumatic drug (DMARD) prescription since onset of symptoms of rheumatoid arthritis (RA) over the last 2 decades in Spain.
Review of medical records of 865 patients diagnosed with RA living in Spain and attended in specialty care settings of the National Health System. The principal variable was the lag time between the onset of symptoms of RA and the date of first DMARD therapy prescription. Analyses were performed by year and five-year periods and differences between groups were assessed by χ(2) test, Student t test and analysis of variance.
Sociodemographic and clinical characteristics corresponded to a typical cross-sectional population of patients diagnosed with RA. The median lag time between symptom onset and first DMARD therapy was 14 months (6-36) for the whole group. However, a significant shortening of time to first DMARD was observed over the last two decades (-4.59±0.2 months by year; P<001). Shortening of time to first DMARD was mainly due to a shortening of time to first visit with specialists since onset of symptoms with a smaller decrease in time from first visit to first prescription of a DMARD agent.
A significant shortening in the lag time to first DMARD therapy was observed over the last 2 decades in Spain, being a significant reduction in the time to first visit with a specialists its major cause.
分析西班牙过去20年中类风湿关节炎（RA）症状出现至首次使用改善病情抗风湿药（DMARD）处方的延迟时间变化。
回顾西班牙865例确诊为RA且在国家卫生系统专科护理机构就诊的患者的病历。主要变量是RA症状出现至首次DMARD治疗处方日期之间的延迟时间。按年份和五年期进行分析，组间差异通过χ²检验、学生t检验和方差分析进行评估。
社会人口统计学和临床特征与确诊为RA的典型横断面人群相符。整个组症状出现至首次DMARD治疗的中位延迟时间为14个月（6 - 36个月）。然而，在过去20年中观察到首次使用DMARD的时间显著缩短（每年缩短 - 4.59±0.2个月；P < 0.01）。首次使用DMARD时间的缩短主要是由于症状出现至首次就诊专家的时间缩短，而从首次就诊到首次开具DMARD药物处方的时间减少幅度较小。
在西班牙过去20年中，首次DMARD治疗的延迟时间显著缩短，首次就诊专家时间的显著减少是其主要原因。
