Treatment delays for patients with new onset rheumatoid arthritis presenting to an Australian early arthritis clinic

Early treatment ensures optimal outcomes in rheumatoid arthritis (RA). This study aimed to quantify treatment delays in RA patients and to explore factors influencing delay and resultant patient outcomes.Data were obtained for 88 patients presenting to an Early Arthritis Clinic (EAC) in Australia between 2008 and 2015 with a new diagnosis of RA. Date and details of symptom onset, initial general practice (GP) presentation, GP referral and review at EAC was collected. Patient demographics and clinical features were analysed for outcomes and features predictive of delay.Median overall delay from symptom onset to rheumatology review was 26.4 weeks. Patient delay (8.7 weeks) was the longest delay and predicted overall delay. Delays for GP referral and time to EAC review were 4 and 8.4 weeks. Increased overall delay was predicted by lower fatigue and disease activity scores (DAS28) and increased tender joint counts (TJC). Patient delay was increased by socioeconomic disadvantage. Increased GP delay was associated with lower DAS28, and higher TJC and ESR. Patients seen within 16 weeks had greater improvement in DAS28 and probability of remission at 6 months.In this Australian EAC setting, patient delay was the greatest contributor to RA treatment delay. Delays in treatment were associated with lower disease severity and socioeconomic disadvantage. Remission was more likely after prompt initiation of treatment. This article is protected by copyright. All rights reserved