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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Facilitators and barriers in diagnosing rheumatoid arthritis as described by general practitioners: a Danish study based on focus group interviews

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  • Anne Sofie Baymler Lundberg
  • Bente Appel Esbensen
  • Martin Bach Jensen
  • Ellen Margrethe Hauge
  • Annette de Thurah
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OBJECTIVE: To explore the perspectives of general practitioners (GPs) on facilitators and barriers in diagnosing rheumatoid arthritis (RA).

DESIGN: Qualitative study based on focus group interviews, and using latent thematic analysis.

SETTING: General practices from Central Region Denmark.

SUBJECTS: Eleven GPs participated in three different focus groups. Forty percent were female, the mean age was 53 years (range 37-64), and the mean since medical licensing was 16 years (range 5-23). Sixty percent of the GPs worked in an area served by a university hospital, and 40% were served by a regional hospital.

MAIN OUTCOME MEASURE: Themes describing experiences and reflections about facilitators and barriers in diagnosing Rheumatoid Arthritis.

RESULTS: Four themes emerged: (A) If the patient is not a textbook example, (B) The importance of maintaining the gatekeeper function, (C) Difficulties in referral of patients to the rheumatologist, and (D) Laboratory tests-can they be trusted? Barriers were identified in all themes, but facilitators only in A, C, and D. The overarching theme was Like finding a needle in a haystack.

CONCLUSION: The GPs found several barriers for diagnosing RA (symptom awareness, GP's gatekeeper function, suboptimal collaboration with rheumatologists and limitations in laboratory tests). They identified education, more specific tests and better access to rheumatologists as possible facilitators for diagnosing RA. To facilitate earlier referral of suspected RA in general practice and strengthen mutual information and collaboration, future research should focus on these facilitators and barriers.KeypointsEarly diagnosis is essential for the prognosis of RA, and the diagnostic process begins in general practice.Suggested facilitators: training courses in interpretation of laboratory tests and the clinical manifestation of RA, and videos on joint examinations.Suggested barriers: compliance with the gatekeeper function, suboptimal collaboration with rheumatologists, limitations of laboratory tests, and diversity of clinical manifestations.

Original languageEnglish
JournalScandinavian Journal of Primary Health Care
Volume39
Issue number2
Pages (from-to)222-229
Number of pages8
ISSN0281-3432
DOIs
Publication statusPublished - Jun 2021

    Research areas

  • early diagnosis, focus group interviews, patient delay, primary health care, Rheumatoid arthritis, General Practitioners, Humans, Middle Aged, Focus Groups, Denmark, Adult, Female, Qualitative Research, Arthritis, Rheumatoid/diagnosis

ID: 65440767