{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:00:16Z","timestamp":1790697616997,"version":"4.1.0"},"reference-count":51,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"unspecified","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Heart Foundation","award":["Tom Simpson Fund"],"award-info":[{"award-number":["Tom Simpson Fund"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,10]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterise the symptom, comorbidity and diagnostic journey of adult and older adolescent patients with postural orthostatic tachycardia syndrome (POTS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants \u226516 years old with physician-confirmed POTS who enrolled in the Australian POTS registry between 1 May 2021 and 30 April 2024 were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>500 participants enrolled in the Australian POTS registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Health-related quality of life and symptom severity were assessed using validated patient-reported outcome measures, including the Composite Autonomic Symptom Score, EuroQol 5-Dimension-5 Level (EQ-5D), Gastroparesis Cardinal Symptom Index (GCSI), Fatigue Severity Scale (FSS) and the 5-point hypermobility index scores. Sociodemographics, diagnostic journey details and comorbidities were obtained via self-reported questionnaires and reconciled with medical records by the clinical team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 500 participants (86.8% females, 92.7% White; mean age 31.3\u00b111.7 years), the median diagnostic delay was 3.0 years (IQR 9.0; mean 6.7 years), with 25.5% experiencing a delay of \u226510 years. Despite being young and highly educated, 22.0% were unemployed or unable to attend education. Infection was the most frequently identified proximal trigger and accounted for 39.4% of cases. Higher autonomic symptom burden, as reported on the Composite Autonomic Symptoms Score (COMPASS-31) questionnaire, was associated with greater fatigue (FSS: 56.0\u00b18.8 vs 48.0\u00b114.5; p&lt;0.001), gastrointestinal symptoms (GCSI: 1.60\u00b10.77 vs 0.89\u00b10.63; p&lt;0.001), increased healthcare utilisation and worse quality of life (EQ-5D utility: 0.547\u00b10.237 vs 0.717\u00b10.200; p&lt;0.001), assessed using Mann-Whitney U and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests as appropriate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>POTS is associated with significant diagnostic delays, high healthcare utilisation, substantial symptom burden, educational, social and occupational impacts. Patient-reported outcome measures such as the COMPASS-31 questionnaire can assist in identifying high-risk individuals. Systemic healthcare reform is urgently needed to improve access to timely diagnosis and effective treatment for individuals living with POTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12621001034820.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119165","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:01:16Z","timestamp":1790694076000},"page":"e119165","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Multimorbidity, functional impairment and health-related quality of life in postural orthostatic tachycardia syndrome: findings from an Australian observational cohort study"],"prefix":"10.1136","volume":"16","author":[{"given":"Marie-Claire","family":"Seeley","sequence":"first","affiliation":[{"name":"Australian 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of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Langdon","sequence":"additional","affiliation":[{"name":"Australian Dysautonomia and Arrhythmia Research Collaborative, Adelaide University, Adelaide, South Australia, Australia"},{"name":"Flinders College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Chieng","sequence":"additional","affiliation":[{"name":"Australian Dysautonomia and Arrhythmia Research Collaborative, Adelaide University, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Bailey","sequence":"additional","affiliation":[{"name":"Australian Dysautonomia and Arrhythmia Research Collaborative, Adelaide University, Adelaide, South Australia, 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