Background and aims The mean average time to diagnosis (TTD) in the UK for axial SpA is currently 8.29 yearsi. However, it should be possible to ensure diagnosis within 12 months of symptom onset to optimise clinical outcomesii. Current evidence suggests significant variability in the patient journey, particularly within primary care, where patients have repeat consultations for axial SpA related symptoms before being referred onward to rheumatologyiii. The National Axial Spondyloarthritis Society (NASS) TTD patient survey assesses where in the pathway patients experience most delays and the factors that may be driving these pinch points. Methods We developed a patient self-administered post-diagnosis axial SpA online survey form, and analysed the results along the pathway. Data were collected from 534 patients diagnosed since January 2021. Results The average time from first GP appointment to rheumatology referral was the longest wait, at 4.33 years (53% of the total delay). Other elements of the pathway were (mean): • 2.49 years (31%) from experiencing symptoms to seeking help from a GP, • 0.39 years (5%) waiting for a first rheumatology appointment following referral, • 0.88 years (11%) for the time from first appointment in rheumatology to formal diagnosis. Patients also reported seeing healthcare practitioners multiple times pre diagnosis. Physiotherapists (66%, n = 353) and GPs (63%, n = 337) were seen most frequently, with chiropractors (19%, n = 103) and osteopaths (17%, n = 93) seeing around a fifth of patients repeatedly. P001 Figure 1.Proportional split of average (mean) time to diagnosis by pathway. P001 Figure 2.Number of visits to other Health Care Professionals (HCPs) before receiving a formal diagnosis. Whilst specialist clinics are not possible everywhere, patients in these settings get a swifter diagnosis due to increased expertise, greater access to co-located MSK radiology services and expedited triage out of general rheumatology pools. References 1. Eddison J, et al. www.actonaxialspa.com; Webb D, et al. Act on axial SpA: A Gold Standard time for the diagnosis of axial SpA (2021); Al-Attar M, et al. Ann Rheum Dis 2021;80(Suppl 1):757.

中文翻译：

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P001 中轴型脊柱关节炎的患者诊断之旅 - 初级保健的挑战和专业中轴型 SpA 服务的积极影响


背景和目标 英国中轴型 SpA 的平均诊断时间 （TTD） 目前为 8.29 岁i。然而，应该有可能确保在症状出现后 12 个月内得到诊断，以优化临床结局ii。目前的证据表明，患者旅程存在显著差异，尤其是在初级保健领域，患者在被转诊至风湿病学之前会反复询问中轴型 SpA 相关症状iii。美国国家中轴型脊柱关节炎协会 （NASS） TTD 患者调查评估了患者在通路中经历最多延误的部位以及可能导致这些夹点的因素。方法 我们开发了一个患者自我管理的诊断后轴向 SpA 在线调查表，并沿路径分析了结果。数据收集自 2021 年 1 月以来诊断的 534 名患者。结果 从第一次 GP 预约到风湿病转诊的平均等待时间最长，为 4.33 年（占总延迟的 53%）。该途径的其他要素是（平均值）： • 从出现症状到寻求全科医生帮助需要 2.49 年 （31%）， • 转诊后等待第一次风湿病预约 0.39 年 （5%）， • 从第一次风湿病预约到正式诊断的时间为 0.88 年 （11%）。患者还报告在诊断前多次看过医疗保健从业者。物理治疗师 （66%， n = 353） 和全科医生 （63%， n = 337） 就诊频率最高，脊椎按摩师 （19%， n = 103） 和整骨医生 （17%， n = 93） 重复就诊约五分之一的患者。P001 图 1.按途径划分的平均（平均）诊断时间的比例划分。P001 图 2.在接受正式诊断之前去看其他医疗保健专业人员 （HCP） 的次数。 虽然并非在所有地方都可以开设专科诊所，但由于专业知识的增加、更容易获得同地协作的 MSK 放射学服务以及从一般风湿病库中快速分诊，这些环境中的患者可以更快地得到诊断。参考资料 1.Eddison J 等人 www.actonaxialspa.com;Webb D 等人。作用于轴向 SpA：诊断轴向 SpA 的金标准时间（2021 年）;Al-Attar M 等人 Ann Rheum Dis 2021;80（增刊 1）：757。