Abstract Background/Aims Socioeconomic factors play a significant role in axial spondyloarthritis (axSpA). Current literature suggests blue-collar employment, being female, and a low education level are linked with longer time to diagnosis and worse outcomes. Delayed diagnosis remains a significant challenge in people with axSpA and is associated with greater functional impairment and socio-economic costs. We aimed to examine the variables associated with delays to presentation to secondary care (and thereby diagnosis), with a focus on socio-economic factors. Methods This was a service evaluation looking at patient records attending the axSpA clinic from January 2023 to September 2024. Collected data included: deprivation index of postal code, gender, type of employment, smoking history, time from GP presentation to referral to rheumatology, time from referral to appointment in axSpA clinic, and time from GP presentation to diagnosis. Results 130 patients were analysed, of which 83 (63.8%) were female. The median age was 46 years old; 69 patients (53.1%) had a regular smoking history, and 57 patients (43.8%) were white-collar or ex-white-collar workers. Fifty-nine patients (39.2%) were diagnosed with axSpA. Median time from GP referral to appointment in axSpA clinic was 8 weeks (57.5 days). Overall, people diagnosed with axSpA waited for a median of 7.95 years and 8.13 years from symptom onset to referral and diagnosis, respectively. Surrogate variables for lower socio-economic status such as blue-collar employment and smoking history, as well as being male were all associated with increased time between onset of symptoms and diagnosis. There was no association between deprivation index and time to referral in our cohort. Conclusion Blue-collar employment, smoking history and being male were all associated with increased time between presentation at GP and referral to axSpA clinic. The diagnostic delay seen in males contrasts with published data and might be explained by the particularities of our region, e.g. higher proportion of men employed in blue-collar work (65%) compared to women. Once referred to secondary care, patients were seen and diagnosed within an acceptable timeframe, as per GIRFT guidelines. Significant delays exist between presentation to GP and referral to axSpA clinic, particularly in vulnerable/ deprived groups. Education directed to primary care regarding referral pathways for axSpA and the presentation of inflammatory back pain may reduce these delays, improve outcomes and lower costs, and should be targeted for certain vulnerable groups. Disclosure H. Butt: None. C. Kelly: None. T. Alcala: None. D. Alderton: None. S. Premraj: None. E. Ntatsaki: None. T. Gudu: None.
Butt et al. (Wed,) studied this question.