Vasculitis care marred by diagnostic delays, limited access to medications

Several factors, such as diagnostic delays and limited access to medications, pose as barriers to vasculitis care, according to a study.

A team of investigators performed two quantitative surveys from September 2022 to June 2023 in 100 patients with vasculitis and 31 healthcare professionals (HCPs) through the Vasculitis Foundation Canada and the Canadian Rheumatology Association. They conducted secondary descriptive analyses of the data to explore patient and HCP perspectives of vasculitis care challenges.

Diagnostic delays occurred frequently, with the majority of patients (66 percent) reporting initial misdiagnoses and about one in three (35 percent) consulting five or more doctors before receiving a diagnosis of vasculitis. More than half of patients (57 percent) referred to rheumatology waited for more than a month for an appointment.

On the other hand, HCPs cited a lack of family physicians (74 percent) as the greatest barrier to vasculitis care, followed by long waitlists (58 percent) and inappropriate referrals (48 percent).

More than two in five patients (44 percent) reported challenges associated with medication use, specifically related to adverse effects, out-of-pocket costs, and limited insurance coverage. Moreover, about four in five patients (83 percent) visited the hospital at least once for vasculitis-related symptoms, often due to disease flare.

Among HCPs, four in five (80 percent) reported challenges with prescribing or accessing medications for vasculitis, as well as issues related to prior authorizations and step therapy protocols. The most common medication associated with such challenges was rituximab.

“Targeted interventions, such as improving referral pathways, expanding provider availability, and reducing administrative burdens, are essential to improving access for this vulnerable population,” the investigators said.