Comment on: Delay in presentation to primary care physicians is the main reason why patients with rheumatoid arthritis are seen late by rheumatologists

Abstract

Sir, We read with interest the report by Kumar et al. [1] and felt that it may be of value to highlight some of the results of our contemporaneous regional survey, which support and extend their findings. Our study explored the accessibility and quality of secondary care rheumatology services for people with inflammatory arthritis (IA) in the West Midlands [2]. A total of 1877 patients were surveyed in 11 rheumatology centres in February 2005. These centres did not include the Sandwell and West Birmingham NHS Trust, where the data in the study by Kumar et al. [1] were collected. We focused on patients diagnosed with IA in the previous 2 yrs (n = 236) to provide a picture of recent practice and minimize recall bias with better access to accurate information in the medical notes. Mean age was 57 yrs (s.d. 15); 156 (66.1%) were females; 163 (69.1%) were diagnosed with RA. Information on the timeframe from symptom onset to seeing their general practitioner (GP), subsequent referral to a rheumatologist, being seen in clinic, receiving a diagnosis and commencement of DMARD therapy was recorded by the clinician with the aid of the medical notes and the patient.