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Efforts to Increase Public Awareness May Result in More Timely Diagnosis of Rheumatoid Arthritis

Zafar, Sara; Badsha, Humeira MD, ABC Rheumatol, ABC Internal Med, FACR (Rheumatol), FAMS (Rheumatol)*; Mofti, Ayman MD, ABC Rheumatol, ABC Internal Med*; Delosantos, Arlene CN*; Altares, Janice CN*; Matudio, Gerald CN*; Kong, Kok Ooi MBBS, MRCP(UK), FRCP(Edin), FAMS(Rheumatol)

JCR: Journal of Clinical Rheumatology: September 2012 - Volume 18 - Issue 6 - p 279–282
doi: 10.1097/RHU.0b013e3182676975
Original Articles

Background Patients with rheumatoid arthritis (RA) in the United Arab Emirates (UAE) have previously been found to have a long delay to diagnosis and low utilization of disease-modifying antirheumatic drugs (DMARDs). Over the past 5 years, support groups, awareness programs, and public campaigns have been instituted in the region.

Aim This study aimed to assess whether such initiatives have affected the lag to diagnosis previously observed.

Methods Demographic, disease, and treatment data on the first 100 patients meeting American College of Rheumatology (1987) criteria for RA, presenting to our practice for the first time, were compared with similar data from 2006 on patients presenting to a different musculoskeletal clinic.

Results Subjects had a mean age of 40.2 (±11.0) years (42.2 [±12.3] years in the previous study; Student t test, P > 0.05). Rheumatoid factor was positive in 62% of subjects, whereas 73% were titer positive in the previous study (χ2 test, P > 0.05). There was a mean reduction in lag time from symptom onset to diagnosis by 45.8%, from 14.4 (±15.6) to 7.8 (±12.1) months (Student t test, P = 0.001) between data sets. The lag to initial DMARD was also reduced by a mean of 34.9%, from 19.2 (±24) to 12.5 (±21.7) months (Student t test, P = 0.04).

Conclusions Findings suggest that the lag to diagnosis and initiation of DMARD therapy has reduced significantly among patients with RA in the United Arab Emirates, over the past 5 years. This may be attributed to the inception of patient support groups and increasing public awareness. Larger studies are needed to substantiate this further and to address whether shorter lag times can positively influence rates of disease remission and quality of life for our patients with RA (as this was a region specific study).

From the *Al Biraa Arthritis Clinic, Dubai, United Arab Emirates; and †Department of Rheumatology, Allergy & Immunology, Tan Tock Seng Hospital, Singapore, Singapore.

Sara Zafar is a fourth-year MBChB student at the University of Edinburgh, Scotland.

The authors declare no conflict of interest.

Correspondence: Humeira Badsha, MD, Al Biraa Arthritis and Bone Clinic, Al Wasl Rd (Al Manara), Dubai, United Arab Emirates. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.