Factors associated with time to presentation of patients to rheumatology clinics at the National Hospital of Sri Lanka

Abstract

Background: Delay in diagnosis of rheumatic diseases is associated with less favorable outcomes. However, there is paucity of local data on diagnostic delay. Therefore, the aim of this study was to describe factors associated with time to presentation of patients to rheumatology clinics at the National Hospital of Sri Lanka (NHSL).Methods: A descriptive cross-sectional study was conducted at the three rheumatology clinics of NHSL. A total of 120 patients whose first presen- tation to the clinics had been within 6 weeks period to the date of data collection were recruited using systematic sampling. An interviewer administered questionnaire was used. Patient delay, healthcare delay and total delay were the three main aspects of delays considered.Results: The median total delay in presentation was 12 months, patient delay was 6 months and healthcare delay was 6 months. Increasing age (p=0.013), high monthly income (p=0.007) and patients diagnosed with rheumatoid arthritis (p=0.018) showed a significant positive association with delay in presentation while mechanical backache (p=0.022), neck pain (p=0.044) and systemic lupus erythematosus (p=0.044) showed negative association with delay in presentation. Gender, education level, pattern of joint involvement and health seeking behaviors were not associated with delay.Conclusion: There was a significant delay in presentation of the overall study population to the rheumatology clinics. Increasing age, high monthly income and patients diagnosed with rheumatoid arthritis was associated with delayed presentation.