Use of primary health care and radiological imaging preceding a diagnosis of rheumatoid arthritis: a nationwide cohort study in Denmark

Annette de Thurah; Henry Jensen; Thomas Maribo; Martin B Jensen; Annelli Sandbæk; Ellen-Margrethe Hauge; Linda Aa Rasmussen

doi:10.1093/rheumatology/keac306

Use of primary health care and radiological imaging preceding a diagnosis of rheumatoid arthritis: a nationwide cohort study in Denmark

Annette de Thurah^*, Henry Jensen, Thomas Maribo, Martin B Jensen, Annelli Sandbæk, Ellen-Margrethe Hauge, Linda Aa Rasmussen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

5 Citations (Scopus)

Abstract

Objective. To explore health-care use in the 12 months preceding a diagnosis of RA in Denmark. Methods. We conducted a population-based cohort study using data from national registries. Every patient diagnosed with RA in 2014–18 was matched to 10 reference individuals without RA from the Danish background population. Health-care use was defined as contacts to general practitioners, contacts to private practicing physiotherapists, and X-rays of hands and/or feet performed in primary or secondary care. We estimated the monthly contact rates for patients and references in the 12 months preceding the diagnosis, and we compared incidence rates for health-care use in each month between the two groups while adjusting for sociodemographic characteristics and comorbidity. Results. We included 7427 patients with RA and 74 270 references. Patients with RA had increasing contact rates with general practitioners and physiotherapists from 6 to 8 months before the diagnosis. Compared with references, women with RA had statistically significantly more contacts to general practitioners and physiotherapists during all 12 months. A similar contact pattern was seen in men, albeit less distinct. The number of X-rays increased slightly from 8 months before the diagnosis, with a steep increase in the last 3 months. Conclusion. Increased contacts to general practitioners and physiotherapists were seen in all 12 months preceding the RA diagnosis, intensifying in the last 6 to 8 months. Imaging increased from 3 months before the diagnosis. This indicates an opportunity to expedite referral to specialist care and ensure earlier diagnosis of RA.

Original language	English
Journal	Rheumatology (Oxford, England)
Volume	62
Issue	2
Pages (from-to)	555–564
Number of pages	10
ISSN	1462-0324
DOIs	https://doi.org/10.1093/rheumatology/keac306
Publication status	Published - 1 Feb 2023

Keywords

Arthritis, Rheumatoid/diagnostic imaging
Cohort Studies
Denmark/epidemiology
Female
General Practitioners
Humans
Male
Primary Health Care
Registries

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10.1093/rheumatology/keac306

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@article{9f652e8a32f44601b81cd2075fe0a606,

title = "Use of primary health care and radiological imaging preceding a diagnosis of rheumatoid arthritis: a nationwide cohort study in Denmark",

abstract = "Objective. To explore health-care use in the 12 months preceding a diagnosis of RA in Denmark. Methods. We conducted a population-based cohort study using data from national registries. Every patient diagnosed with RA in 2014–18 was matched to 10 reference individuals without RA from the Danish background population. Health-care use was defined as contacts to general practitioners, contacts to private practicing physiotherapists, and X-rays of hands and/or feet performed in primary or secondary care. We estimated the monthly contact rates for patients and references in the 12 months preceding the diagnosis, and we compared incidence rates for health-care use in each month between the two groups while adjusting for sociodemographic characteristics and comorbidity. Results. We included 7427 patients with RA and 74 270 references. Patients with RA had increasing contact rates with general practitioners and physiotherapists from 6 to 8 months before the diagnosis. Compared with references, women with RA had statistically significantly more contacts to general practitioners and physiotherapists during all 12 months. A similar contact pattern was seen in men, albeit less distinct. The number of X-rays increased slightly from 8 months before the diagnosis, with a steep increase in the last 3 months. Conclusion. Increased contacts to general practitioners and physiotherapists were seen in all 12 months preceding the RA diagnosis, intensifying in the last 6 to 8 months. Imaging increased from 3 months before the diagnosis. This indicates an opportunity to expedite referral to specialist care and ensure earlier diagnosis of RA.",

keywords = "Arthritis, Rheumatoid/diagnostic imaging, Cohort Studies, Denmark/epidemiology, Female, General Practitioners, Humans, Male, Primary Health Care, Registries",

author = "{de Thurah}, Annette and Henry Jensen and Thomas Maribo and Jensen, {Martin B} and Annelli Sandb{\ae}k and Ellen-Margrethe Hauge and Rasmussen, {Linda Aa}",

note = "{\textcopyright} The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].",

year = "2023",

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day = "1",

doi = "10.1093/rheumatology/keac306",

language = "English",

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Use of primary health care and radiological imaging preceding a diagnosis of rheumatoid arthritis: a nationwide cohort study in Denmark. / de Thurah, Annette; Jensen, Henry; Maribo, Thomas et al.
In: Rheumatology (Oxford, England), Vol. 62, No. 2, 01.02.2023, p. 555–564.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Use of primary health care and radiological imaging preceding a diagnosis of rheumatoid arthritis

T2 - a nationwide cohort study in Denmark

AU - de Thurah, Annette

AU - Jensen, Henry

AU - Maribo, Thomas

AU - Jensen, Martin B

AU - Sandbæk, Annelli

AU - Hauge, Ellen-Margrethe

AU - Rasmussen, Linda Aa

PY - 2023/2/1

Y1 - 2023/2/1

N2 - Objective. To explore health-care use in the 12 months preceding a diagnosis of RA in Denmark. Methods. We conducted a population-based cohort study using data from national registries. Every patient diagnosed with RA in 2014–18 was matched to 10 reference individuals without RA from the Danish background population. Health-care use was defined as contacts to general practitioners, contacts to private practicing physiotherapists, and X-rays of hands and/or feet performed in primary or secondary care. We estimated the monthly contact rates for patients and references in the 12 months preceding the diagnosis, and we compared incidence rates for health-care use in each month between the two groups while adjusting for sociodemographic characteristics and comorbidity. Results. We included 7427 patients with RA and 74 270 references. Patients with RA had increasing contact rates with general practitioners and physiotherapists from 6 to 8 months before the diagnosis. Compared with references, women with RA had statistically significantly more contacts to general practitioners and physiotherapists during all 12 months. A similar contact pattern was seen in men, albeit less distinct. The number of X-rays increased slightly from 8 months before the diagnosis, with a steep increase in the last 3 months. Conclusion. Increased contacts to general practitioners and physiotherapists were seen in all 12 months preceding the RA diagnosis, intensifying in the last 6 to 8 months. Imaging increased from 3 months before the diagnosis. This indicates an opportunity to expedite referral to specialist care and ensure earlier diagnosis of RA.

AB - Objective. To explore health-care use in the 12 months preceding a diagnosis of RA in Denmark. Methods. We conducted a population-based cohort study using data from national registries. Every patient diagnosed with RA in 2014–18 was matched to 10 reference individuals without RA from the Danish background population. Health-care use was defined as contacts to general practitioners, contacts to private practicing physiotherapists, and X-rays of hands and/or feet performed in primary or secondary care. We estimated the monthly contact rates for patients and references in the 12 months preceding the diagnosis, and we compared incidence rates for health-care use in each month between the two groups while adjusting for sociodemographic characteristics and comorbidity. Results. We included 7427 patients with RA and 74 270 references. Patients with RA had increasing contact rates with general practitioners and physiotherapists from 6 to 8 months before the diagnosis. Compared with references, women with RA had statistically significantly more contacts to general practitioners and physiotherapists during all 12 months. A similar contact pattern was seen in men, albeit less distinct. The number of X-rays increased slightly from 8 months before the diagnosis, with a steep increase in the last 3 months. Conclusion. Increased contacts to general practitioners and physiotherapists were seen in all 12 months preceding the RA diagnosis, intensifying in the last 6 to 8 months. Imaging increased from 3 months before the diagnosis. This indicates an opportunity to expedite referral to specialist care and ensure earlier diagnosis of RA.

KW - Arthritis, Rheumatoid/diagnostic imaging

KW - Cohort Studies

KW - Denmark/epidemiology

KW - Female

KW - General Practitioners

KW - Humans

KW - Male

KW - Primary Health Care

KW - Registries

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DO - 10.1093/rheumatology/keac306

M3 - Journal article

C2 - 35713514

SN - 1462-0324

VL - 62

SP - 555

EP - 564

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

IS - 2

ER -

Use of primary health care and radiological imaging preceding a diagnosis of rheumatoid arthritis: a nationwide cohort study in Denmark

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