ArticleRheumatology advances in practice2024
Progressive improvement in time to diagnosis in axial spondyloarthritis through an integrated referral and education system.
Article in Rheumatology advances in practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Diagnostic delay in axial spondyloarthritis: demographic, socioeconomic, and healthcare barriers in the West Bank, Palestine.Clinical rheumatology · 2026Article
- Treatment satisfaction, disease severity, and health-care use in patients with axial spondyloarthritis in the United States and Europe.Rheumatology (Oxford, England) · 2026Article
- Year in Review: Axial Spondyloarthritis.Mediterranean journal of rheumatology · 2026Review
- Biomarkers in axial spondyloarthritis diagnosis: from clinical signs to multi-omics integration.Frontiers in immunology · 2026Review
- Patient Diagnostic Journey and Time to Diagnosis in Axial Spondyloarthritis: A Retrospective Cohort Study Using US Claims Data.Rheumatology and therapy · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: To assess the delay in the diagnosis of axial SpA (axSpA) in a real-world cohort over a 16-year period and to evaluate factors associated with this delay. We implemented a service improvement project and evaluated its effectiveness in improving time to diagnosis of axSpA. Methods: A cohort of axSpA patients newly diagnosed between January 2008 and December 2023 were studied. Surveys were carried out in 2013, 2017, 2019 and 2023 to assess time to diagnosis, which was divided into four periods from onset of inflammatory back pain to year of axSpA diagnosis. The time to diagnosis over the study period was analysed using a statistical process control chart. Results: Over the study period, 988 referrals were received and 366 (37%) had axSpA. There was a progressive increase in the number of females with axSpA. The mean time to diagnosis significantly decreased from 9.8 years (s.d. 1.2) in 2008 to 1.0 years (s.d. 1.0) in 2023. The greatest delay was from the onset of back pain to first seeing their general practitioners (GPs; mean 3.2 years). There was a significant improvement in the mean time to diagnosis across the time periods through the service improvement interventions. Conclusion: Structural and organizational change in triage, referral and clinic pathways has led to earlier recognition of axSpA. This is further enhanced through an integrated education program and awareness campaign for the public, GPs and healthcare professionals, including physiotherapists. With continuous quality improvement cycles, we achieved our aim of reducing the mean time to diagnosis to 1 year.
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