Symptom recognition and perceived urgency of help-seeking for rheumatoid arthritis and other diseases in the general public: a mixed method approach

Objective: Clinical outcomes in Rheumatoid arthritis (RA) are improved if the disease is treated early. However, treatment is often significantly delayed as a result of delayed help seeking by patients who fail to recognise its symptoms or the need for rapid medical attention. We conducted two studies to investigate the role of symptom recognition in help-seeking for the symptoms of RA and compared this with angina and bowel cancer. Methods: We conducted a qualitative interview study with 31 individuals and a postal survey of 1088 members of the general public (all without RA). Both studies used vignettes describing the symptoms of RA, bowel cancer and angina. Participants made causal attributions and rated the perceived seriousness of the symptoms and the urgency with which they would seek medical help if confronted with these symptoms. Results: Only a small proportion of participants in both studies recognised the symptoms of RA, whereas the symptoms of bowel cancer and angina were readily recognised by many participants and considered to be more serious and to require more rapid medical attention (Z values of 14.7 to 34.2, p<.001). Conclusion: Accurate symptom attribution and the perception that symptoms are indicative of a serious underlying condition are both important drivers for rapid help seeking. In the case of angina and bowel cancer, recent campaigns have promoted not only recognition of symptoms and their seriousness, but also emphasised the consequences of not seeking timely help. Our results suggest that these consequences should also be addressed in any public health campaign for RA