P005 Early inflammatory arthritis combined nurse and therapist clinic

Abstract

Abstract Background/Aims NICE guidelines recommend patients have ongoing access to a multidisciplinary team (MDT). However, ensuring all patients are seen by physiotherapy, podiatry, and occupational therapy (OT), when needed, can be challenging. The aim of the project was for patients to be seen by a therapist, in the first six months of their disease. The plan was to provide treatment and encourage long-term self-management, by providing knowledge of when self-referring to the different therapy services would be beneficial. Methods A Nurse and therapist pilot clinic was implemented at the first Disease Modifying Anti-Rheumatic Drugs review appointment. The clinic allowed 15-minutes with a specialist nurse to discuss medication issues and drug counselling. This was followed by 30-minutes with a therapist, to discuss any functional needs and objectively assess any joint issues and to provide treatment. Patients were educated about their condition and signposted to information. Patients were also provided with self-management advice and informed about the role of MDT members. Written or emailed advice was provided. Patients were invited to complete an anonymous questionnaire evaluating their experience. Results 60 patients were seen in the first three months. Personalised therapy input was given to each patient; however, hand exercises and joint protection advice was given to over 60% of patients. Other therapy input included exercises for other specific joints that were problematic, the provision of wrist splints and relaxation advice. Results of the patient questionnaire showed 98% of patients felt they ‘definitely’ had more information to help manage their arthritis and 100% felt they knew where to go to get more information, if needed. Patients also had a greater understanding of the role of physiotherapy and OT. 88% of patients were confident they would ‘definitely’ know when to ask to be referred to these specialities in the future. Less than 15% of patients required further therapy input following the appointment. Conclusion The pilot clinic received excellent patient feedback and fulfilled the aims of providing therapy input, early in patient’s journey. Patients liked the convenience of seeing both the professionals in one visit, felt they had gained more information on their condition and were able to help themselves. Patient’s comments included ‘feeling more supported’ and ‘being able to help myself’. One experienced therapist seeing the patients was more cost effective than separate physiotherapy and OT appointments. The next stage will be to invite all newly diagnosed patients into this clinic as part of an early inflammatory arthritis pathway. We will then audit the impact on therapy referral rates and assess if early intervention reduces the number of therapy referrals long-term, encourages patient self-management and improves patient outcomes. Disclosure H. Harrison: None. R. Allan: None.