Exploring the patient journey to diagnosis of Gaucher disease from the perspective of 212 patients with Gaucher disease and 16 Gaucher expert physicians

• Published in: Molecular genetics and metabolism 2017-11, Vol.122 (3), p.122-129
• Main Authors: Mehta, Atul, Belmatoug, Nadia, Bembi, Bruno, Deegan, Patrick, Elstein, Deborah, Göker-Alpan, Özlem, Lukina, Elena, Mengel, Eugen, Nakamura, Kimitoshi, Pastores, Gregory M., Pérez-López, Jordi, Schwartz, Ida, Serratrice, Christine, Szer, Jeffrey, Zimran, Ari, Di Rocco, Maja, Panahloo, Zoya, Kuter, David J., Hughes, Derralynn
• Format: Article
• Language: English
• Subjects: Child; Delayed Diagnosis; Diagnosis; Gaucher disease; Gaucher Disease - diagnosis; Humans; Male; Medicine - statistics & numerical data; Patient survey; Patients - psychology; Physician survey; Physicians - psychology; Risk Factors; Surveys and Questionnaires
• ISSN: 1096-7192; 1096-7206
• DOI: 10.1016/j.ymgme.2017.08.002

Gaucher disease (GD) is a rare hereditary disorder caused by a deficiency of the lysosomal enzyme β-glucocerebrosidase. Diagnosis is challenging owing to a wide variability in clinical manifestations and severity of symptoms. Many patients may experience marked delays in obtaining a definitive diagnosis. The two surveys reported herein aimed to explore the patient journey to diagnosis of GD from the perspectives of Gaucher expert physicians and patients. Findings from the surveys revealed that many patients experienced diagnostic delays and misdiagnoses, with nearly 1 in 6 patients stating that they were not diagnosed with GD for 7years or more after first consulting a doctor. Physicians and patients both reported multiple referrals to different specialties before a diagnosis of GD was obtained, with primary care, haematology/haematology-oncology and paediatrics the main specialties to which patients first presented. Splenomegaly, thrombocytopenia, anaemia and bone pain were reported as the most common medical problems at first presentation in both surveys. These findings support a clear need for straightforward and easy-to-follow guidance designed to assist non-specialists to identify earlier patients who are at risk of GD. •Physician and patient surveys confirm that many patients with GD experienced diagnostic delays and/or misdiagnoses•Patients experienced multiple referrals to different specialties before a diagnosis of GD was obtained•Primary care, haematology/haematology-oncology and paediatrics were the main specialties to which patients first presented•Splenomegaly, thrombocytopenia, anaemia and bone pain were the most common medical problems at first presentation•There is a need for disease-specific guidance to help less experienced medical personnel identify patients with GD