Fast track clinic for early diagnosis of polymyalgia rheumatica: Impact on symptom duration and prednisolone initiation

Line L Frølund, Christoffer Våben, Mette Dam, Søren G Kjær, Berit D Nielsen, René D Østgård, Kresten K Keller

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

Objectives: To evaluate the efficacy of a fast track clinic (FTC) for patients suspected of polymyalgia rheumatica (PMR) regarding symptom duration, prednisolone initiation before rheumatological assessment, number of hospital contacts before diagnosis, and cancer diagnosis. Methods: It is a retrospective cohort study with a one year follow-up period. Patients referred to the FTC (1st August 2016 to 25th June 2019) were compared to a historical cohort of PMR patients (1st August 2014 to 1st August 2016). Referral criteria are: age over 50, symptoms of PMR but not cranial GCA, and increased C-reactive protein. Data were obtained from patient journals. Results: Ninety-seven PMR patients in the historical cohort and 113 FTC patients, of whom 83 patients had PMR, were included. The median (interquartile range) number of days from symptom onset until PMR diagnosis were 53 (31–83) days in the FTC versus 80 (58–132) days in the historical cohort (P < 0.001). Prednisolone was prescribed before rheumatological assessment to 11% in the FTC versus 42% in the historical cohort (P < 0.001). Patients in the FTC had significantly fewer contacts with the hospital before the diagnosis compared with the historical cohort. Four patients in the FTC were diagnosed with a cancer, all of which were found by imaging. Conclusion: The FTC reduced the time from symptom onset until diagnosis, lowered prednisolone initiation before rheumatological assessment, and resulted in fewer hospital visits. The frequency of cancers was low in patients suspected of PMR and cancers were discovered by imaging.

Original languageEnglish
Article number105185
JournalJoint Bone Spine
Volume88
Issue5
Number of pages6
ISSN1297-319X
DOIs
Publication statusPublished - Oct 2021

Keywords

  • Early Detection of Cancer
  • Giant Cell Arteritis
  • Humans
  • Polymyalgia Rheumatica/diagnosis
  • Prednisolone/therapeutic use
  • Retrospective Studies

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