Saif Saba, Kithlew Rizwana
Combined Military Hospital, Lahore Medical College Institute of Dentistry, Lahore, Pakistan.
Combined Military Hospital, Lahore Medical College Institute of Dentistry, Lahore, Pakistan..
J Pak Med Assoc. 2022 Nov;72(11):2204-2208. doi: 10.47391/JPMA.4598.
To study the time taken by individuals from onset of symptoms related to rheumatic diseases to approaching a rheumatologist, and to establish the various delaying factors.
The cross-sectional study was conducted at the Department of Medicine, Division of Rheumatology, Combined Military Hospital, Lahore, Pakistan, from August 1 to December 31, 2020, and comprised patients of either gender diagnosed with inflammatory arthritis or other connective tissue diseases. Demographic and clinical data, including antibody status, was recorded. Time lag in visiting a rheumatologist at different levels and factors causing the delay were identified. Data was analysed using SPSS 22.
Of the 235 patients, 186(79%) were females and 49(21%) were males. The overall median age was 39 years (interquartile range: 29-50 years.). Of the total, 52(22%) patients presented in <12 weeks of symptom onset to a rheumatologist. Median time for patient-related delay was 6 months (interquartile range: 1-12 months), while the median time for physician-related delay was 8 months (interquartile range: 2-42 months). The median time for appointment delay was 1 week (interquartile range: 1-2 weeks). Median duration from the start of symptoms to evaluation by a rheumatologist was 24 months (interquartile range: 6-72 months). The most common delaying factor 131(55.7%) was lack of proper assessment at the primary care level. No association was found between age and time of presentation (p>0.05), but male gender, higher socioeconomic status, higher education level and rheumatoid factor negativity presented earlier compared to the rest (p<0.05 each).
The primary care physician's delayed referral was found to be the most important factor resulting in delayed presentation to a rheumatologist.
研究个体从出现风湿性疾病相关症状到就诊于风湿病专家所花费的时间，并确定各种延迟因素。
这项横断面研究于2020年8月1日至12月31日在巴基斯坦拉合尔联合军事医院内科风湿病科进行，纳入了诊断为炎性关节炎或其他结缔组织疾病的患者，无论性别。记录了人口统计学和临床数据，包括抗体状态。确定了在不同层面就诊于风湿病专家的时间间隔以及导致延迟的因素。使用SPSS 22对数据进行分析。
235例患者中，186例（79%）为女性，49例（21%）为男性。总体中位年龄为39岁（四分位间距：29 - 50岁）。其中，52例（22%）患者在症状出现后<12周就诊于风湿病专家。患者相关延迟的中位时间为6个月（四分位间距：1 - 12个月），而医生相关延迟的中位时间为8个月（四分位间距：2 - 42个月）。预约延迟的中位时间为1周（四分位间距：1 - 2周）。从症状开始到由风湿病专家评估的中位持续时间为24个月（四分位间距：6 - 72个月）。最常见的延迟因素131例（55.7%）是基层医疗水平缺乏适当评估。未发现年龄与就诊时间之间存在关联（p>0.05），但与其他情况相比，男性、社会经济地位较高、教育水平较高和类风湿因子阴性的患者就诊较早（各p<0.05）。
发现基层医疗医生转诊延迟是导致患者延迟就诊于风湿病专家的最重要因素。
