The journey of patients with musculoskeletal complaints in Europe: a cross-sectional European survey

Abstract

Rheumatic and musculoskeletal diseases (RMDs) are highly prevalent and place a significant socioeconomic burden on healthcare systems. However, their diagnosis and management remain suboptimal. This study aimed to analyze healthcare-seeking behaviors, key touchpoints, access barriers, and diagnostic pathways for individuals experiencing initial or progressive symptoms of RMDs across European countries. Understanding these differences is crucial for improving early access to specialized care. A cross-sectional online survey was conducted with 141 participants from seven European countries, including 67 rheumatologists and 39 general practitioners (GPs). The survey assessed initial healthcare-seeking behaviors, delays in diagnosis, and perceived barriers to specialized rheumatology care. Descriptive and inferential statistical methods were used for data analysis. The survey indicated that individuals experiencing RMD symptoms primarily seek information through internet research and GP consultations. Despite their role as primary gatekeepers, GPs' knowledge of RMDs was generally perceived as moderate to low. Significant disparities in access to rheumatological diagnostics, time to diagnosis, and treatment, coupled with organizational barriers between primary and specialist care, were reported across most countries. Spanish participants reported the longest diagnostic delays, while Swedish respondents experienced the shortest. Additionally, access to sacroiliac MRI was limited in Hungary and Spain, whereas glucocorticoids were widely available across all countries according to the participants. The study also revealed that early arthritis clinics were most accessible in the UK from the participants' perspectives. Significant variations in healthcare access for patients with RMDs persist across Europe. Strategies to enhance early detection, including GP education and improved specialist accessibility, are essential to optimizing patient outcomes.

Keywords: Healthcare access barriers; Patient experience; Patient journey; Rheumatic and musculoskeletal diseases, surveys and questionnaires; Surveys and questionnaires.