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中轴型脊柱关节炎:克服早期诊断障碍——早期炎症性背痛服务。

Axial Spondyloarthritis: Overcoming the Barriers to Early Diagnosis-an Early Inflammatory Back Pain Service.

机构信息

Rheumatology Department, Whipps Cross Hospital, Barts Health NHS Trust, London, UK.

Royal Free London NHS Trust, London, England.

出版信息

Curr Rheumatol Rep. 2020 Aug 17;22(10):59. doi: 10.1007/s11926-020-00923-6.

Abstract

PURPOSE OF REVIEW

To discuss the challenges to early diagnosis of axial spondyloarthritis (axSpA) and present the impact an early inflammatory back pain service (EIBPS) had on diagnostic delay in the UK.

RECENT FINDINGS

Diagnostic delay in axSpA varies greatly worldwide, and has continued in the UK at an average of 8.5 years. Education, public awareness, and accessibility to inflammatory back pain (IBP) pathways are some of the key barriers to achieving a prompt diagnosis. A recent national inquiry has highlighted insufficiencies in the availability of specialist axSpA services and limited provision of education and training to first contact practitioners and allied healthcare providers. We demonstrate diagnostic delay in axSpA can be successfully reduced to 3 years when an early inflammatory back pain service is embedded within a rheumatology department alongside a local educational and awareness campaign. Sharing these experiences and outcomes will enable other departments to engage in best practice and achieve similar results, facilitating a timely and accurate diagnosis.

摘要

目的综述

讨论强直性脊柱炎(axSpA)早期诊断的挑战,并介绍英国早期炎症性背痛服务(EIBPS)对诊断延迟的影响。

最近的发现

axSpA 的全球诊断延迟差异很大,在英国平均为 8.5 年。教育、公众意识以及获得炎症性背痛(IBP)途径是实现快速诊断的一些关键障碍。最近的一项全国性调查强调了专科 axSpA 服务的可用性不足,以及对初级接触者和辅助医疗保健提供者的教育和培训的有限提供。我们证明,当早期炎症性背痛服务与当地的教育和宣传活动一起嵌入风湿病学部门时,axSpA 的诊断延迟可以成功缩短至 3 年。分享这些经验和结果将使其他部门能够采用最佳实践并取得类似的结果,从而实现及时和准确的诊断。

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