Canadian Patients With Axial Spondyloarthritis Require Almost a Decade To Be Diagnosed Leading to Severe Functional Limitation. Results From the International Map of Axial Spondyloarthritis (IMAS).

IF 1.5 Q3 RHEUMATOLOGY

Musculoskeletal Care Pub Date : 2024-12-01 DOI:10.1002/msc.70010

Proton Rahman, Marco Garrido-Cumbrera, Sherry Rohekar, Michael G Mallinson, Elie Karam, Algis V Jovaisas, Nigil Haroon, Jeff Beach, Artur J de Brum-Fernandes, Martin Cohen, Jonathan Chan, Jose Correa-Fernández, Patrick Leclerc, Robert D Inman

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引用次数: 0

Abstract

Objective: To evaluate the sociodemographic characteristics and disease-related factors associated with diagnostic delay in Canadian patients with axial spondyloarthritis (axSpA).

Methods: Data from 542 Canadian patients who participated in the International Map of Axial Spondyloarthritis online survey were analysed. Diagnostic delay was calculated as the difference between age at diagnosis and age at onset of the first symptoms reported by participants. Univariate and multivariate analyses were used to evaluate possible factors associated with diagnostic delay.

Results: The mean age (± SD) of the surveyed participants was 44.3 ± 13.9 years and 63.1% were female. The average diagnostic delay was 9.0 ± 10.5 years (median, 5.0 years; interquartile range, 1.0-13.8). In the multivariate regression analysis, the three variables most strongly associated with longer diagnostic delay were use of nonsteroidal anti-inflammatory drugs (NSAIDs) (B = 2.991; 95% CI = 1.075-4.909), medium or high functional limitation (B = 1.541; 95%CI = 0.186-2.896), and number of HCPs seen before diagnosis (B = 1.524, 95%CI = 1.072-1.977).

Conclusion: Diagnostic delay continues to be a barrier to optimal care for Canadian axSpA patients. Significant diagnostic delay, associated with a high number of HCP visits prior to diagnosis, high use of NSAIDs, and marked functional limitation in daily life, illustrate the convoluted axSpA patient journey.

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加拿大的中轴性脊柱炎患者需要近十年的时间才能确诊，导致严重的功能限制。结果来自国际轴性脊椎关节炎地图（IMAS）。

目的：评估加拿大轴性脊柱炎（axSpA）患者诊断延迟的社会人口学特征和疾病相关因素。方法：对542名参加国际轴性脊柱炎地图在线调查的加拿大患者的数据进行分析。诊断延迟计算为诊断年龄与参与者报告的首次症状发病年龄之间的差异。单因素和多因素分析用于评估与诊断延迟相关的可能因素。结果：调查对象的平均年龄（±SD）为44.3±13.9岁，女性占63.1%。平均诊断延迟为9.0±10.5年(中位数为5.0年；四分位数范围1.0-13.8)。在多因素回归分析中，与较长诊断延迟最相关的三个变量是使用非甾体抗炎药（NSAIDs） (B = 2.991；95% CI = 1.075-4.909)，中高功能限制(B = 1.541；95%CI = 0.186 ~ 2.896)，诊断前HCPs数（B = 1.524, 95%CI = 1.072 ~ 1.977）。结论：诊断延迟仍然是加拿大axSpA患者获得最佳护理的障碍。显著的诊断延迟，与诊断前HCP的大量就诊，非甾体抗炎药的大量使用以及日常生活中明显的功能限制有关，说明了axSpA患者的曲折历程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Musculoskeletal Care RHEUMATOLOGY-

CiteScore

2.30

自引率

7.70%

发文量

期刊介绍： Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.