{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:46:21Z","timestamp":1788997581375,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T00:00:00Z","timestamp":1615766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Early referral forms a crucial part in early inflammatory\/rheumatoid arthritis (EI\/RA) recovery. Delayed decisions to refer can lead to severe incapacity and emotional distress for individuals and family and feelings of lost time. How patients with EI\/RA experience early referral decisions in Primary Care is an under explored area and warrants further investigation.<\/jats:p><\/jats:sec>Aim<\/jats:title>To explore how patients newly diagnosed with EI\/RA experienced their early contacts with Primary Care as they negotiated their journey through the referral process into secondary care.<\/jats:p><\/jats:sec>Design and setting<\/jats:title>Qualitative face\u2010to\u2010face interviews with newly diagnosed EI\/RA patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>In\u2010depth semi\u2010structured interviews were conducted to explore patients\u2019 experiences of referral from first symptoms to General Practitioner referral. All participants were interviewed within 2 weeks of being diagnosed in Secondary Care. Data analysis was conducted using interpretative phenomenological analysis.<\/jats:p><\/jats:sec>Findings<\/jats:title>All participants in this study described having experienced struggles with their navigation through Primary Care towards diagnosis and specialist EI\/RA services. This struggle comprised five key elements: \u2018family persuasion\u2019, \u2018lack of continuity in care\u2019, \u2018pushing for referral\u2019, \u2019strained relations\u2019 and \u2018lost time\u2019.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The delays experienced by patients when attempting to reach an early referral decision in Primary Care cause frustration for those presenting with EI\/RA, partly because they do not feel heard. There is a significant impact on patients and their families when referral to specialist care is delayed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.1546","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T10:14:25Z","timestamp":1615803265000},"page":"495-503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["\u2018Lost time\u2019<\/i>. Patients with early inflammatory\/rheumatoid arthritis and their experiences of delays in Primary Care"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5947-7378","authenticated-orcid":false,"given":"Frances","family":"Chilton","sequence":"first","affiliation":[{"name":"Rheumatology Department Warwick Hospital NHS Foundation Trust Warwick Warwickshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Bradley","sequence":"additional","affiliation":[{"name":"Division of Health Psychology College of Life, Health and Environmental Sciences Worcester University Worcester Worcestershire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Academic Unit Nursing and Midwifery College of Health, Life and Environmental Sciences Worcester University Worcester Worcestershire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"The state of play in UK rheumatology: Insights into service pressures and solutions","author":"British Society of Rheumatology","year":"2015"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27691"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X682297"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(96)00221-3"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(99)00145-8"},{"key":"e_1_2_12_7_1","volume-title":"Making shared decision\u2010making a reality. 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