Table 1

Gaps in care and their associated drivers evident across the journey of patients with RA

Stage of patient journeyGaps in careDrivers*
Awareness and preventionDelays in patients seeking medical adviceLow public awareness14
Lack of patient education19
ReferralDelayed referrals from PCPs to rheumatologistLimited awareness of PCPs on signs and symptoms of RA20
Long waiting times for specialists21
Joint stiffness and inflammation are common for many other conditions
Lack of knowledge regarding the referral pathway or the importance of rapid referral21
DiagnosisDelay in diagnosisComplex diagnostic requirements14
Limited availability of imaging facilities21 22
Shortage of rheumatologists22
Limited number of HCPs trained to interpret diagnostic results (including imaging)14
Treatment and management (pharmacological and non-pharmacological)Delayed treatment initiation
Poor patient adherence to therapy
Lack of coordinated treatment
Budgetary cap and restrictive clinical recommendations regarding choice of therapy22
Disease management not aimed at optimising quality of life23
Deviation from recommendations, or difficulty in implementing them into clinical practice22
Lack of regular review and engagement with patients’ needs24
Treatment adherence23
Competing lifestyle factors23
Follow-upLack of monitoring
Suboptimal patient outcomes
Capacity constraint—leading to long waiting time for examinations with imaging modalities22
Lack of regularity in follow-up care22
Access to rheumatologists22
  • *List not exhaustive.

  • HCP, healthcare professional; PCP, primary care professional; RA, rheumatoid arthritis.