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Table 2 Summary of Key Themes

From: Perceived barriers to integrated care in rheumatoid arthritis: views of recipients and providers of care in an inner-city setting

Barriers

Non-Professional

Professional

 

Patients

Carers

Secondary Care Specialists

General Practitioners

Specialist Referral

   • Delay in referral from primary care

   • Delay in referral from primary care

• Delay in referral from primary care

• Quality of referral influences prioritisation

• Role as gatekeepers to specialist care

• Need for positive blood tests

• Referral linked to personal confidence and role perception

Routine follow up and DMARD monitoring

• Lack of time with rheumatologist

• Cancellation and postponement of appointments

• Perceived lack of knowledge of GPs

• Poor primary/secondary care interaction

• Waiting times in clinic

• Transport difficulties

• Perceived lack of knowledge of GPs

• Poor primary/secondary care interaction

• Time pressures

• Paucity of follow up appointments

• Lack of monitoring by GPs

• Lack of regular review

• Lack of clarity of role in monitoring

Access to care in times of need

   • Difficulty of access during a flare

   • No specific comments

• Seeing patients urgently impeded by time pressures and paucity of appointments.

• GPs not providing emergency care

• Lack of knowledge of RA treatment

• Preference for personal knowledge of rheumatologist to access secondary care urgently