Republished: A systematic literature review of strategies promoting early referral and reducing delays in the diagnosis and management of inflammatory arthritis

Villeneuve, Édith; Nam, Jackie; Bell, Mary; Deighton, C.; Felson, David T.; Hazes, J. M. W.; McInnes, Iain B.; Silman, Alan J.; Solomon, Daniel H.; Thompson, Alexandra; White, Patience H.; Bykerk, Vivian P.; Emery, Paul

doi:10.1136/postgradmedj-2011-201063rep

Cited by 19 publications

(9 citation statements)

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“…An important goal with diagnostic criteria for arthritis should be the possibility of early identification of patients with ongoing TMJ arthritis with high risk of chronicity and damage because there is evidence that early arthritis treatment allows less damage, suffering and treatment . The American College of Rheumatology recently updated their classification criteria for rheumatoid arthritis with a primary focus on establishing clinical findings important for early diagnosis of cases with high risk of chronicity and damage whilst not excluding more established cases .…”

Section: Discussionmentioning

confidence: 99%

Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

Peck

Goulet

Lobbezoo

et al. 2014

J of Oral Rehabilitation

307

249

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Background There is a need to expand the current temporomandibular disorder (TMD) classification to include less common, but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing, and further criteria refinement. Methods A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria, and the ability to operationalize and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMD taxonomy was presented for feedback at international meetings. Results Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders, and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalized diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. Conclusions The expanded TMD taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalize and test the proposed taxonomy and diagnostic criteria.

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Section: Discussionmentioning

confidence: 99%

Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

Peck

Goulet

Lobbezoo

et al. 2014

J of Oral Rehabilitation

307

249

View full text Add to dashboard Cite

show abstract

“…Four major categories emerged: (1) animals and/or animal products used as traditional medicine ( Table 1), (2) beliefs and values behind the traditional treatment of RA, (3) sources and traditional learning pathway of indigenous practices on RA, and (4) ethical aspects of the indigenous practices on RA. The findings are presented under each major category with quotes from the participants at the end of each paragraph.…”

Section: Resultsmentioning

confidence: 99%

“…The chronic inflammation leads to joint destruction and permanent deformities. The major concern with RA is persistent pain and other adverse health consequences as a result of chronic systemic inflammation (1,2). Hence, timely and rational treatment of RA is important (2).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Animal and Animal Products for Rheumatoid Arthritis Treatment: An Explorative Study in Odisha, India

et al. 2020

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Severe fatigue, pain, deformity, and disability, are the major concerns for rheumatoid arthritis (RA). The extreme pain experienced by the patients often force them to experiment with various indigenous substances including animals and animal products. However, there is little evidence on the use of animals or animal products as traditional medicine in RA. Hence, this study was aimed to explore the experience and perception of patients toward the use of animals and animal products for the treatment of RA. A qualitative, explorative study was conducted at the outpatient department of Rheumatology of a tertiary care medical college and hospital at Cuttack, Odisha, India. Out of 113 patients with RA, 18 patients gave history of use of animal and/or animal products and were selected for in-depth interviews. The content analysis methods were used for data analysis. Four major categories emerged: (1) prevailing patterns of traditional treatment of RA using animals, (2) beliefs and values behind the traditional treatment of RA, (3) sources and traditional learning pathway of indigenous practices on RA, and (4) ethical aspects of the indigenous practice of using animals and/or animal products in the treatment of RA. This study revealed the practice of eating dead animals to get relief from RA. However, there was hardly any perceived positive outcome of the practice; which indicates the lack of awareness of rational, scientific, treatment, and prevalence of irrational and unethical practices for the treatment of RA. Hence, community awareness, social mobilization, and newer screening tools are necessary to improve the timely detection and prevention of irrational treatment practices among RA patients.

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“…When considering interventions to address this problem, it has proved informative to account for those components of the patient journey that contribute to delay. These include the time from symptom onset to assessment in primary care, primary care assessment to secondary care rheumatology referral, rheumatology referral to rheumatology assessment and rheumatology assessment to DMARD initiation [ 8 ]. Individual components of this journey have been shown to vary markedly across healthcare infrastructures in Europe [ 7 ], with the lag between symptom development and primary care consultation being particularly important in the UK [ 6 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Components of treatment delay in rheumatoid arthritis differ according to autoantibody status: validation of a single-centre observation using national audit data

et al. 2016

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Objective. To determine whether time to treatment following symptom onset differs between RA patients according to autoantibody status.Methods. A single-centre retrospective analysis of a UK early RA inception cohort was first undertaken to identify those components of the patient journey that differed by serological subtype. Data from a UK national audit of early inflammatory arthritis patients was accessed to replicate the key finding.Results. A total of 173 RA patients were diagnosed over a 31-month period, of whom 80 (46%) were ACPA/RF double-seropositive (ACPA+/RF+), 53 (31%) ACPA−/RF−, 17 (10%) ACPA+/RF− and 23 (13%) RF+/ACPA−. Overall, ACPA+/RF+ patients experienced significantly longer symptom duration before DMARD initiation. This was accounted for by delays in their presentation to primary care following symptom onset—a finding that was robustly confirmed in an independent dataset of 2192 UK early RA patients. In contrast, ACPA−/RF− patients were significantly more likely to experience delays in DMARD initiation after presenting to secondary care.Conclusion. Causes of treatment delays in early RA differ according to patients’ autoantibody status. More insidious symptom onset and/or distinct health-seeking behaviours among ACPA+/RF+ patients may contribute to late presentations in primary care, whereas ACPA−/RF− patients experience delayed diagnosis and treatment in secondary care. These observations inform the research agenda, potentially influencing the design of service delivery for early arthritis patients.

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Republished: A systematic literature review of strategies promoting early referral and reducing delays in the diagnosis and management of inflammatory arthritis

Abstract: This review identified three main areas of delay to care for patients with IA and potential solutions for each. A co-ordinated effort will be required by the rheumatology and primary care community to address these effectively.

Cited by 19 publications

References 50 publications

Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

Use of Animal and Animal Products for Rheumatoid Arthritis Treatment: An Explorative Study in Odisha, India

Components of treatment delay in rheumatoid arthritis differ according to autoantibody status: validation of a single-centre observation using national audit data

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