Rheumatoid arthritis is a common disease associated with significant articular and extra-articular complications. Outcomes are improved if treatment is started early and the first three months after the onset of symptoms have been suggested to represent a therapeutic window of opportunity. Unfortunately many patients miss this window. Reasons for delayed treatment include delays on the part of the patient in seeking help, delays on the part of the primary care physician in referring the patient to a rheumatologist and delays on the part of the rheumatologist in assessing the patient and commencing therapy. The relative contributions of these levels of delay vary between different countries. Reasons underlying delays at each of these levels will be discussed and potential solutions will be reviewed.
Disclosure of Interest None Declared