Comment on: Delay in presentation to primary care physicians is the main reason why patients with rheumatoid arthritis are seen late by rheumatologists: reply
1Department of Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust and 2MRC Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham, UK
Correspondence to: K. Raza, MRC Centre for Immune Regulation, Division of Immunity and Infection, The University of Birmingham, Birmingham B15 2TT, UK. E-mail: k.raza{at}bham.ac.uk
SIR, The data reported by Sandhu et al. [1] support and significantly extend our finding that the majority of the delay in assessing patients with RA in secondary care lies at the level of the patient seeking medical advice [2]. Re-analysis of our data, looking at the proportion of patients with RA who waited more than 6 weeks before consulting their GP, reveals a figure virtually identical (62%) to that reported by Sandhu et al. [1] for patients with inflammatory arthritis in general. Our study was conducted within a single National Health Service (NHS) Trust serving an ethnically diverse and very socioeconomically deprived population. The strength of the data reported by Sandhu et al. [1] is that it derives from a survey of many units serving a very wide geographic area and is likely to include patients from a broader socioeconomic background than our study did. Many studies have been conducted addressing why patients with other diseases (in particular, ischaemic heart disease and cancers) delay in seeking medical advice [3, 4] and the need for such research in RA has now been clearly identified. We have recently completed a qualitative study addressing this. We hope that our findings, when published, will help inform decisions about how this problem can be addressed at a public health level.
Disclosure statement: The authors have declared no conflicts of interest.
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- Sandhu RS, Treharne GJ, Justice EA, et al. Comment on: Delay in presentation to primary care physicians is the main reason why patients with rheumatoid arthritis are seen late by rheumatologists. Rheumatology (2008) 47:559–60.
[Free Full Text] - Kumar K, Daley E, Carruthers DM, et al. Delay in presentation to primary care physicians is the main reason why patients with rheumatoid arthritis are seen late by rheumatologists. Rheumatology (2007) 46:1438–40.
[Abstract/Free Full Text] - Pattenden J, Watt I, Lewin RJ, et al. Decision making processes in people with symptoms of acute myocardial infarction: qualitative study. Br Med J (2002) 324:1006–9.
[Abstract/Free Full Text] - Smith LK, Pope C, Botha JL. Patients’ help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet (2005) 366:825–31.[CrossRef][Web of Science][Medline]
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