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Table 7 Codebook for primary care physician interviews

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

Name Description
Patient characteristics Any mention of these sociodemographic factors, as they relate to diagnosing, “textbook cases”, thoughts about axSpA, etc.
a. Age
b. Weight-status/obesity
c. Sex/gender
d. Socioeconomic status
e. Employment
f. Multiple comorbidities
Approaches to diagnosing axSpA All quotes falling under this code should refer to axSpA specifically, not general back pain, acute injuries, etc.
a. Typical presentation of axSpA
b. Clues within workup pointing towards axSpA
c. Triggering events
d. Medical history
e. Imaging and lab tests if axSpA is suspected
f. Ruling out other diagnoses
Reasons for diagnostic delay a. Back pain is common and causes are multifactorial
b. axSpA is rare and has vague/nebulous symptoms
c. Challenges faced by PCPs regarding rare/specialized conditions
d. Structural barriers within healthcare system
e. Wary of drug seeking behavior
Overcoming delays Factors that could reduce the diagnostic delay (note: can include the need to implement a screening process)
Referrals a. Access
b. Physical therapy
c. Rheumatology
d. Other specialists
Screening a. Barriers = what makes screening difficult
b. Facilitators = what would make screening easier or likely to be implemented
c. General thoughts = current approaches, brainstorming other strategies currently being used or that could be used (e.g., NLP)
axSpA Awareness Brief response to question about whether they and/or colleagues are aware of axSpA and whether they believe the diagnostic delay is an issue
Screening questions a. Question 1: Have you suffered from back pain for more than 3 months?
b. Question 2: Did your back pain start when you were aged 40 or under?
c. Question 3: Did your back pain develop gradually?
d. Question 4: Does your back pain improve with exercise?
e. Question 5: Do you find there is no improvement in your back pain when you rest?
f. Question 6: Do you suffer from back pain at night which improves upon getting up?
g. Recommendations