Table 1 Patient/physician demographic characteristics and patient diagnostic pathways
Patients N = 65 | |
|---|---|
Mean age, years | 33 |
Male, n (%) | 39 (60%) |
Female, n (%) | 26 (40%) |
Current health state (Score: 1, very poor health; 7, excellent health) | |
≤ 4 | 26 (40%) |
Splenectomized, n (%) | 6/64 (9.3%) |
Diagnosis | |
Median (IQR) time from symptom presentation to diagnosis, months | 1.5 (0.5–5.7) |
Symptom presentation to first consultation, months | 0.7 (0.1–3.0) |
First consultation to diagnosis | 0.5 (0.2–1.0) |
Patients with a median time from initial presentation to ITP diagnosis > 6 months, n (%) | 9/55 (16%) |
Patients in whom diagnosis of ITP confirmed as a result of another health condition, n (%) | 2 (3%) |
Delay in diagnosis, n (%) | 21 (32%) |
Awaiting additional test results | 8 (38%) |
Specialist reference | 7 (33%) |
Patient support following diagnosis, n (%) | |
Family/friends | 59 (91%) |
Physicians | 50 (77%) |
Nurses | 24 (37%) |
Patients who needed more support during the diagnosis process, n (%) | 27 (42%) |
Physicians | 20 (74%) |
Family/friends | 13 (48%) |
Patient support groups | 11 (41%) |
Physicians N = 21 | |
|---|---|
Average total patient caseload | 625 |
Number of ITP patients seen in the last 12 months | 81 |
Practice setting | |
Private care | 12 (57%) |
Specialty cancer center | 5 (24%) |
University teaching hospital and community teaching hospital | 4 (19%) |
Year of qualification | |
Before 1981 | 1 (5%) |
1981–1993 | 3 (14%) |
1994–2003 | 5 (24%) |
2004–2014 | 10 (48%) |
After 2014 | 2 (10%) |
Diagnosis | |
Median (IQR) time from symptom presentation to diagnosis, months | 0.25 (0.25–0.62) |
Primary ITP | 70% |
Secondary ITP | 30% |
Reasons for delay in diagnosis | |
Specialist reference | 13 (62%) |
Exclusion of other potential causes | 12 (57%) |
Causes of secondary ITP | |
Systemic lupus erythematosus | 11 (52%) |
Drug-induced thrombocytopenia | 11 (52%) |
Hepatitis C virus | 10 (48%) |
Chronic lymphocytic leukemia | 8 (38%) |
Human immunodeficiency virus | 7 (33%) |
Investigation rates (asymptomatic vs high symptom burden) | |
Spleen evaluation | 12 (57%) vs 16 (76%) |
Coomb’s test | 5 (24%) vs 13 (76%) |
H. pylori | 3 (14%) vs 8 (28%) |
Computed tomography scan | 1 (5%) vs 7 (33%) |
Platelet specific assay | 0% vs 4 (19%) |
Misdiagnosis rates | |
Upto 25% patients are misdiagnosed | 14 (67%) |
26–50% patients are misdiagnosed | 5 (24%) |
Most commonly misdiagnosed conditions | |
Drug induced thrombocytopenia | 12 (63%) |
Leukemia | 11 (58%) |
Aplastic anemia | 10 (53%) |