ArticleBMC rheumatology2025
Management and treatment of early rheumatoid arthritis, process and barriers among rheumatologists in Spain: a Delphi consensus.
Article in BMC rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundThe early diagnosis of rheumatoid arthritis (RA) is essential in order to start the treatment as soon as possible; this process usually begins in primary care and the diagnosis is subsequently confirmed by a rheumatologist. The objective of this study was to increase the knowledge about the barriers rheumatologists perceive to early diagnosis in patients with RA in Spain. It is necessary to optimize the diagnostic process.
methodsAn online, two-round Delphi consensus survey was conducted from 01/07/2022 to 24/10/2022. The survey comprised statements concerning the goals of RA treatment, the role of primary care in early diagnosis and the barriers and obstacles that hinder early diagnosis among others. A consensus was reached when at least 80% of participants agreed with each statement.
resultsAll participants agreed that patients with RA should be referred to rheumatology as soon as possible, preferably within the first six weeks after the first symptoms. In addition, they mostly thought that the existence of new-onset arthritis units within rheumatology services was important. This could allow a reduction in both time to attention in the consultation and treatment initiation. Moreover, prior visits to orthopedics, rehabilitation or physical medicine specialties seem to be an obstacle for early diagnosis. An agreement was reached in all the statements regarding the strategies of the National Health Systems and the impact of the COVID-19 pandemic.
conclusionsThe consensus obtained are in line with the current state-of-the-art knowledge. The heterogeneity among rheumatologist´s practices can explain the reason of the lack of consensus in some areas.
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