Aims
Axial spondyloarthritis (axSpA) is a progressive inflammatory condition that causes inflammatory back pain and fatigue. Diagnostic delay is common in axSpA and results in symptom progression and reduced quality of life. This study aimed to review literature surrounding diagnostic delay of axSpA to identify gaps for future research and clinical practice in Australia.
Methods
A literature review of online databases was completed with a focus on determining how diagnostic delay may vary by location and reported barriers or facilitators to timely diagnosis and treatment. Themes from the literature were then synthesised to suggest future research directions for how axSpA is diagnosed in Australia.
Results
The average diagnostic delay of axSpA varies by location but is reported as 5-10 years from symptom onset (1,2). Barriers to timely diagnosis exist at personal, practitioner, and systemic levels, most notably, the shortage of specialist services and poor awareness of the condition. Most attempts to reduce these barriers have occurred in the United Kingdom, with tools to help patient and practitioner awareness, education programs, and the development of Advanced Practice Physiotherapists to improve screening processes (1,2). These strategies have improved referral rates, but long-term impacts on diagnostic delay remain unclear. No recent research has described the diagnostic delay of axSpA, or strategies to improve it, within Australia.
Conclusions
Reducing the diagnostic delay of axSpA remains a key priority for improving outcomes of the condition internationally. This literature review has highlighted the lack of research on the diagnostic delay of axSpA, and attempts to improve this, within Australia. Future research may seek to explore the barriers and facilitators to diagnosis within Australia, as well as ways to adapt other successful programs, such as targeted education, to an Australian context. By understanding these local contextual factors, we can better address the burden of axSpA within Australia.