Patient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis

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dc.contributor.authorBarber, Claire E H
dc.contributor.authorBarnabe, Cheryl
dc.contributor.authorBenseler, Susanne
dc.contributor.authorChin, Ricky
dc.contributor.authorJohnson, Nicole
dc.contributor.authorLuca, Nadia
dc.contributor.authorMiettunen, Paivi
dc.contributor.authorTwilt, Marinka
dc.contributor.authorVeeramreddy, Dwaraka
dc.contributor.authorShiff, Natalie J
dc.contributor.authorSchmeling, Heinrike
dc.date.accessioned2020-03-08T01:02:24Z
dc.date.available2020-03-08T01:02:24Z
dc.date.issued2020-03-06
dc.date.updated2020-03-08T01:02:24Z
dc.description.abstractAbstract Background Early diagnosis and treatment of Juvenile Idiopathic Arthritis (JIA) is essential to optimize outcomes. Wait times (WTs) to consultation with a pediatric rheumatologist consultation is a Canadian quality measure, with benchmarks set at 7 days for systemic JIA (sJIA) and 4 weeks for other JIA categories. In this study we assess WTs for JIA at a single academic center and describe factors associated with longer WTs. Methods This was a retrospective cohort study of 164 patients enrolled in a pharmacogenetic study in Alberta between 2002 and 2018. Limited chart reviews were conducted to evaluate dates of referral and first rheumatology visit to calculate WTs for receipt of pediatric rheumatology care. Cox proportional hazard models identified factors associated with WTs considering variables at the first pediatric rheumatology visit including: JIA category, age, sex, distance to the pediatric rheumatology clinic, number of active joints, pain and C-reactive protein. Results The median age at diagnosis was 8.0 years (interquartile range, IQR 3.5, 12.0) and 46% of patients had oligoarticular JIA. Only 18 patients (11%) were from rural locations. The median WT for all patients met the national benchmark (22 days, IQR, 9, 44) with no statistically significant difference between WTs among JIA categories (p = 0.055). Importantly, the majority of sJIA cases met the 7-day benchmark (67%) with a median WT of 1.5 days. Older age was associated with longer WT (HR 0.94, 95% CI 0.89, 0.98, p = 0.005). Conclusion Median benchmarks were met, however delays in older patients highlight the need for monitoring WTs.
dc.identifier.citationPediatric Rheumatology. 2020 Mar 06;18(1):22
dc.identifier.doihttps://doi.org/10.1186/s12969-020-0413-7
dc.identifier.urihttp://hdl.handle.net/1880/111721
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titlePatient factors associated with waiting time to pediatric rheumatologist consultation for patients with juvenile idiopathic arthritis
dc.typeJournal Article
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