{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:17:51Z","timestamp":1790349471083,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T00:00:00Z","timestamp":1567123200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Timely treatment of patients with Early Rheumatoid Arthritis (ERA) favors a beneficial disease outcome. However, individuals often delay their contact with a healthcare professional (HCP) after ERA-related symptom onset. This study investigates the patients\u2019 perspective on the patient\u2019s journey from RA symptom onset until referral to a specialist.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A subgroup of patients with ERA from the Care in ERA (CareRA) trial were retrospectively interviewed to discuss their initial ERA-related experiences preceding diagnosis, using a bespoke assessment form. The form\u2019s first section focused on initial symptoms and patients\u2019 help-seeking behavior. The second part probed the consulted HCPs\u2019 actions. Additional notes derived from the patient stories were thematically analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 94 patients, pain (97%), swelling (73%) and stiffness (52%), typically in multiple joints, were reported as initial ERA-symptoms. The general practitioner (GP) was generally the first contacted HCP (87%). Frequently reported reasons to visit a HCP were too intense pain (90.4%) and difficulties in performing daily activities (69%). In 44.1% of patients, the HCP suspected ERA at the first visit. Approximately 25% of patients needed &gt;5 visits before ERA detection. GPs mainly referred patients to rheumatologists (71%). Thematic analysis uncovered that often multiple HCPs were involved in the journey to RA detection and referral.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Pain is the most commonly reported initial symptom of ERA and the main reason to visit a HCP, mostly a GP. These GPs play a pivotal role in early detection and correct referral. Furthermore, the patient\u2019s journey seems complex with often multiple HCPs involved.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/rap\/rkz035","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T14:50:18Z","timestamp":1568127018000},"source":"Crossref","is-referenced-by-count":12,"title":["The perspective of patients with early rheumatoid arthritis on the journey from symptom onset until referral to a rheumatologist"],"prefix":"10.1093","author":[{"given":"De Cock","family":"Diederik","sequence":"first","affiliation":[{"name":"Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van der Elst","family":"Kristien","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stouten","family":"Veerle","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peerboom","family":"Donna","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joly","family":"Johan","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Westhovens","family":"Rene","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verschueren","family":"Patrick","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,30]]},"container-title":["Rheumatology Advances in Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/rheumap\/advance-article-pdf\/doi\/10.1093\/rap\/rkz035\/29311366\/rkz035.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"}],"deposited":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T14:50:19Z","timestamp":1568127019000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rheumap\/advance-article\/doi\/10.1093\/rap\/rkz035\/5556820"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,30]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/rap\/rkz035","relation":{},"ISSN":["2514-1775"],"issn-type":[{"value":"2514-1775","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,30]]},"article-number":"rkz035"}}