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Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis
BACKGROUND: Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7 days for systemic JIA (sJIA) and 4 weeks for other...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059295/ https://www.ncbi.nlm.nih.gov/pubmed/32143720 http://dx.doi.org/10.1186/s12969-020-0413-7 |
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author | Barber, Claire E. H. Barnabe, Cheryl Benseler, Susanne Chin, Ricky Johnson, Nicole Luca, Nadia Miettunen, Paivi Twilt, Marinka Veeramreddy, Dwaraka Shiff, Natalie J. Schmeling, Heinrike |
author_facet | Barber, Claire E. H. Barnabe, Cheryl Benseler, Susanne Chin, Ricky Johnson, Nicole Luca, Nadia Miettunen, Paivi Twilt, Marinka Veeramreddy, Dwaraka Shiff, Natalie J. Schmeling, Heinrike |
author_sort | Barber, Claire E. H. |
collection | PubMed |
description | BACKGROUND: Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7 days for systemic JIA (sJIA) and 4 weeks for other JIA categories. In this study we assess WTs for JIA at a single academic center and describe factors associated with longer WTs. METHODS: This was a retrospective cohort study of 164 patients enrolled in a pharmacogenetic study in Alberta between 2002 and 2018. Limited chart reviews were conducted to evaluate dates of referral and first rheumatology visit to calculate WTs for receipt of pediatric rheumatology care. Cox proportional hazard models identified factors associated with WTs considering variables at the first pediatric rheumatology visit including: JIA category, age, sex, distance to the pediatric rheumatology clinic, number of active joints, pain and C-reactive protein. RESULTS: The median age at diagnosis was 8.0 years (interquartile range, IQR 3.5, 12.0) and 46% of patients had oligoarticular JIA. Only 18 patients (11%) were from rural locations. The median WT for all patients met the national benchmark (22 days, IQR, 9, 44) with no statistically significant difference between WTs among JIA categories (p = 0.055). Importantly, the majority of sJIA cases met the 7-day benchmark (67%) with a median WT of 1.5 days. Older age was associated with longer WT (HR 0.94, 95% CI 0.89, 0.98, p = 0.005). CONCLUSION: Median benchmarks were met, however delays in older patients highlight the need for monitoring WTs. |
format | Online Article Text |
id | pubmed-7059295 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-70592952020-03-12 Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis Barber, Claire E. H. Barnabe, Cheryl Benseler, Susanne Chin, Ricky Johnson, Nicole Luca, Nadia Miettunen, Paivi Twilt, Marinka Veeramreddy, Dwaraka Shiff, Natalie J. Schmeling, Heinrike Pediatr Rheumatol Online J Research Article BACKGROUND: Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7 days for systemic JIA (sJIA) and 4 weeks for other JIA categories. In this study we assess WTs for JIA at a single academic center and describe factors associated with longer WTs. METHODS: This was a retrospective cohort study of 164 patients enrolled in a pharmacogenetic study in Alberta between 2002 and 2018. Limited chart reviews were conducted to evaluate dates of referral and first rheumatology visit to calculate WTs for receipt of pediatric rheumatology care. Cox proportional hazard models identified factors associated with WTs considering variables at the first pediatric rheumatology visit including: JIA category, age, sex, distance to the pediatric rheumatology clinic, number of active joints, pain and C-reactive protein. RESULTS: The median age at diagnosis was 8.0 years (interquartile range, IQR 3.5, 12.0) and 46% of patients had oligoarticular JIA. Only 18 patients (11%) were from rural locations. The median WT for all patients met the national benchmark (22 days, IQR, 9, 44) with no statistically significant difference between WTs among JIA categories (p = 0.055). Importantly, the majority of sJIA cases met the 7-day benchmark (67%) with a median WT of 1.5 days. Older age was associated with longer WT (HR 0.94, 95% CI 0.89, 0.98, p = 0.005). CONCLUSION: Median benchmarks were met, however delays in older patients highlight the need for monitoring WTs. BioMed Central 2020-03-06 /pmc/articles/PMC7059295/ /pubmed/32143720 http://dx.doi.org/10.1186/s12969-020-0413-7 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Barber, Claire E. H. Barnabe, Cheryl Benseler, Susanne Chin, Ricky Johnson, Nicole Luca, Nadia Miettunen, Paivi Twilt, Marinka Veeramreddy, Dwaraka Shiff, Natalie J. Schmeling, Heinrike Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
title | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
title_full | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
title_fullStr | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
title_full_unstemmed | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
title_short | Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
title_sort | patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059295/ https://www.ncbi.nlm.nih.gov/pubmed/32143720 http://dx.doi.org/10.1186/s12969-020-0413-7 |
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