Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Facilitators and barriers in diagnosing rheumatoid arthritis as described by general practitioners: a Danish study based on focus group interviews

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

APA

CBE

MLA

Vancouver

Author

Baymler Lundberg, Anne Sofie ; Esbensen, Bente Appel ; Jensen, Martin Bach ; Hauge, Ellen Margrethe ; Thurah, Annette de. / Facilitators and barriers in diagnosing rheumatoid arthritis as described by general practitioners : a Danish study based on focus group interviews. In: Scandinavian Journal of Primary Health Care. 2021 ; Vol. 39, No. 2. pp. 222-229.

Bibtex

@article{19ba5baf775b41269ce42cfaaba89846,
title = "Facilitators and barriers in diagnosing rheumatoid arthritis as described by general practitioners: a Danish study based on focus group interviews",
abstract = "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.",
keywords = "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",
author = "{Baymler Lundberg}, {Anne Sofie} and Esbensen, {Bente Appel} and Jensen, {Martin Bach} and Hauge, {Ellen Margrethe} and Thurah, {Annette de}",
note = "Publisher Copyright: {\textcopyright} 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jun,
doi = "10.1080/02813432.2021.1913925",
language = "English",
volume = "39",
pages = "222--229",
journal = "Scandinavian Journal of Primary Health Care",
issn = "0281-3432",
publisher = "Informa Healthcare",
number = "2",

}

RIS

TY - JOUR

T1 - Facilitators and barriers in diagnosing rheumatoid arthritis as described by general practitioners

T2 - a Danish study based on focus group interviews

AU - Baymler Lundberg, Anne Sofie

AU - Esbensen, Bente Appel

AU - Jensen, Martin Bach

AU - Hauge, Ellen Margrethe

AU - Thurah, Annette de

N1 - Publisher Copyright: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - 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.

AB - 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.

KW - early diagnosis

KW - focus group interviews

KW - patient delay

KW - primary health care

KW - Rheumatoid arthritis

KW - General Practitioners

KW - Humans

KW - Middle Aged

KW - Focus Groups

KW - Denmark

KW - Adult

KW - Female

KW - Qualitative Research

KW - Arthritis, Rheumatoid/diagnosis

UR - http://www.scopus.com/inward/record.url?scp=85105179009&partnerID=8YFLogxK

U2 - 10.1080/02813432.2021.1913925

DO - 10.1080/02813432.2021.1913925

M3 - Journal article

C2 - 33905289

VL - 39

SP - 222

EP - 229

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

SN - 0281-3432

IS - 2

ER -

ID: 65440767