Benefits of Being an Early Bird with your Diagnosis

Benefits of Being an Early Bird with your Diagnosis

Rare diseases and diseases that present differently can be difficult to diagnose. Often a correct diagnosis may require multiple tests and specialists. In a world in which it has become easy to diagnose oneself, often incorrectly, what options exist for patients as they try to navigate the complicated road of symptom presentation to correct diagnosis and treatment. What are the financial implications for patients and the health care system of delayed diagnosis? What are the physical implications for a patient if diagnosis is delayed? How do patients become advocates for their own health, diagnosis and treatment? These are all important questions as it has become increasingly clear that when you treat can be equally as important as how you treat a condition.

A Therapeutic Window

Active rheumatoid arthritis (RA) is characterised by inflammation of the synovial tissue. Lasting structural damage and eventually permanent disability can occur if the condition remains untreated. Previously within two decades of onset over 90% of RA patients would have developed some form of disability, with the economical health care cost on par with that resulting from coronary artery disease (Buckley, 1997). Early diagnosis and initiation of treatment can and has already made head way into changing these statistics. Effective treatment and the prevention of disability are frequently linked to whether a patient receives an early diagnosis. Finsckh (2006) found that early initiation of disease-modifying antirheumatic drugs (DMARDs) led to a 33% decrease in long term progression rates when compared to patients that initiated treatment later. Patients with more aggressive forms benefitted the most. Studies such as this are indicative of a critical period or therapeutic window when treatment has the greatest benefit both short and long term. This gives the best chance of permanently modifying the disease to a milder course. This does, of course, not mean that patients diagnosed later should not be treated or that they will not benefit from such treatment, but rather that we should strive to ensure the earliest possible diagnosis. So how can this be achieved?

Overcoming Obstacles to Early Diagnosis

A number of obstacles exist to obtaining an early diagnosis. These include but are not limited to a delay in patients seeking medical assistance as well as a delay in primary care, where symptoms early in the progression of RA can be non-specific or inclusive. In order to overcome these obstacles a dual approach is required and that is to have primary care doctors as well as patients who are better informed, guiding earlier diagnosis and treatment and improving long term quality of life and patient outcomes. 

According to the American College of Rheumatology a more rapid referral by a primary care doctor to a rheumatologist is key, as in comparison to long term effects there is a relatively narrow period in which to initiate treatment to maximise the benefit a patient will receive. A number of investigations have shown that patients under the care of a rheumatologist as opposed to other physicians maintain a greater level of functionality and improved health outcomes. Furthermore, rheumatologists are more likely to be informed on treatment options, monitoring patients for maximal efficacy and ensuring safe and appropriate use of novel treatments.

ANRF – Knowledge is Key

The role of organisations such as ANRF are multifaceted, not only supporting research in the field but also creating a platform which is informative to both researchers, doctors and patients. In a sea of information, accessible at our finger tips, it is vital to have and be able to identify reliable resources. Recognised foundations and research organisations such as ANRF are often one of the best resources available, catering to the need for trustworthy information for patients, doctors and other important role players such as drug development companies or supporters, such as the family and friends of patients. ANRF provides invaluable resources such as fact sheets which outline the information in a way which is easily understandable to those without a significant medical background, such as patients and their supporters, putting them in the best position to ask relevant questions and advocate for appropriate tests and treatment options. Additionally, ANRF also provides resources useful to researchers and those with a thorough medical knowledge such as rheumatologists giving them access to information regarding new diagnostic tools and therapeutics. 

As this article illustrates one can not underestimate the impact of having factually correct, up to date information. This allows patients to be the best advocate for their own care as well as allowing doctors to be the best advocates for their patients’ care. Furthermore, it gives patients an active role in their own treatment and care, and as has been shown in previous articles, this is psychologically beneficial, reducing feelings of helplessness and isolation often associated with chronic illness. Working together (patients, clinicians, researchers and foundations alike), using an informed approach will accelerate the common objective of improved treatments and eventually a cure.

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Article Author
Arthritis National Research Foundation

The Arthritis National Research Foundation's mission is to provide initial research funding to brilliant, investigative scientists with new ideas to cure arthritis and related autoimmune diseases. Writing articles about the patients affected and the science being done to find a cure shows why we need to come together to #CureArthritis!

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