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Table 3 Patient characteristics contributing to diagnostic delay for patients with axSpA

From: Primary care physician perspectives on barriers to diagnosing axial Spondyloarthritis: a qualitative study

  Sample Quotes
Patients may not interact frequently enough with the health care system D1: And it’s also possible that it might occur in people with less access to healthcare because of socioeconomic reasons.
D23: It could be that patients aren’t going in until a lot later because they don’t want to see a doctor, they’re nervous about the diagnosis …
Patients having multiple issues to discuss D7: They bring in a list and then they say okay, I have a list and if I have a list you have to pay attention to it all and then I’m like when we’re at number ten or number 13, we’re not going there. But we realize it’s a negotiation and the biggest challenge is when you just don’t have time.
D27: I mean, if patients haven’t accessed the medical system often enough or at all, they will come in with a -- like a laundry list of six or seven or eight problems, and I -- my approach is often, like, let’s talk about your top two.
Patients often add back pain onto the list at the last moment D12: They’re clearly the visit’s scheduled for the back pain, and that’s the main theme of the discussion for that visit. … [it] also sometimes comes up when they’re here for something else and they would say, “Oh, by the way, my back has been hurting,” or, “I have a bad back”.
Patients doctor shop and concern about malingering D22: A lot of patients do go from one doctor to the other and that always doesn’t help because the next doctor, they’ve seen the patient for 1 month only and then they start the whole process again, and the patient goes through a battery of tests.
D23: well, but they also hop physicians because they feel like what they’re doing isn’t helping me, but I think that’s the problem is they’re assuming that there aren’t other things that can be addressed or looked at.