E017 An early inflammatory arthritis questionnaire to enable enhanced triage and a scoping exercise to assess clinical utility

Abstract

Abstract Background/Aims The quality of early inflammatory arthritis (EIA) referrals from primary care can vary even with a standardised referral form leading to large numbers of non-EIA patients being seen. Poor utilisation of EIA slots places pressure on an EIA service’s ability to see suspected EIA patients within 3 weeks of referral. To overcome this challenge, a questionnaire was devised to enable enhanced EIA triage and a scoping exercise was carried out to assess clinical utility. Methods 50 patients attending the EIA clinic completed the questionnaire (Table 1) either self-administered or via telephone prior to their appointment. Early Inflammatory Arthritis Screening Questionnaire (Table 1) Positive answers were scored 1 with a maximum score of 11. Following their appointment, the patient diagnosis was collected from patient records. Results Of the 50 patients, 14 (28%) had a confirmed EIA diagnosis and the other 36 (72%) patients had a range of alternative diagnoses. In the confirmed EIA group, the scores ranged from 5-8/11 with an average mean score of 7.0 and median of 7. Further analysis showed patients with a score over 5/11 including symptom duration of 12 months and under (Q1) identified all the confirmed EIA patients. Applying the above criteria to our 50 study patients resulted in 27/50 patients qualifying for an EIA appointment slot and 14/27 (52%) would have been confirmed with EIA. After applying these cut off criteria the sensitivity of the questionnaire was 100% and the specificity was 64%. The non-EIA group scores ranged from 0 - 8/11 with an average mean score of 4.9 and median score of 5. Conclusion In our service triage of EIA referrals on a standardised form resulted in poor utilisation of EIA slots. Triage using the questionnaire improved the EIA slot allocation and increased EIA conversion rate from 28% to 50%. This questionnaire appears to be a promising tool to improve utilisation of EIA appointments. Telephone assessment could be delivered by any member of the multidisciplinary team. Disclosure J. Burton: None. R. Sathananthan: None. S. Levy: None. N. Horwood: None. T. Ahmed: None. R. Suresh: None.