P181 Assessing and improving mental health in axial spondyloarthritis through digital solutions

Abstract

Abstract Background/Aims Mental health issues in axial spondyloarthritis (AxSpA) such as anxiety and depression can affect up to two thirds of patients. We aimed to detect the prevalence of anxiety and depression in our AxSpA patients in order to provide interventions to improve the condition. This is part of our work in the National Axial Spondyloarthritis Society’s (NASS) Aspiring to Excellence programme to improve patient outcomes. We have provided an online mental health assessment and self-management video that signpost patients to psychological help and resources. Methods We used the Hospital Anxiety and Depression Score (HADS) for AxSpA patients attending the clinic in January to March 2020. We also collected the BASDAI, Spinal Pain, BASFI and BASG. The HADS scores are divided into three groups, 0-7 (normal), 8-10 (borderline abnormal) and 11-21 (abnormal). Patients were invited to watch a self-help video on managing anxiety and depression, which we produced in house with our clinical psychologist. Patients were directed to online mental health resources and self-management programmes. Follow up HADS were collected post watching the video. Results All patients met the ASAS criteria for AxSpA. 100 patients were assessed and invited to watch the video. 90/100 (90%) of patients completed the baseline and follow up score. The mean (SD) age was 44.7 (13.2) years. The male:female ratio was 3:1. The mean disease duration was 9 years. The number of patients on biologics was 36 (40%). At baseline, the mean (SD) HADS was 10 (6), BASDAI 4.4 (2.3), Spinal pain 4.2 (3), BASFI 3.7 (2.7) and BASG 4.3 (2.7). The number of patients with a HADS score 0-7 was 28 (31%), 8-10 was 18 (20%) and >11 was 44 (49%). All patients participated in the viewing of the video and used the self-management programme. 34 (38%) patients reported engaging with psychological services such as talking therapies. At follow up, the mean (SD) HADS score was 9 (6), BASDAI 3.7 (2.1), Spinal pain 3.8 (2.2), BASFI 3.4 (2) and BASG 3.9 (2.4). The number of patients with a HADS score 0-7 was 38 (42%), 8-10 was 28 (31%) and >11 reduced to 24 (27%). There was a reduction in the number of patients with HADS >11 (from 49% to 31%) and a trend towards lower HADS (HADS 0-7 increased from 31% to 42%) and AxSpA outcome scores (reduction in all four AS scores from baseline). Conclusion Mental health issues in AxSpA can be improved through the use of digital mental health assessment and self-management programmes. This study shows that this is a useful method of delivering care. There was a trend towards the improvement of the mental health and AS disease activity scores using the digital video. Disclosure A. Chan: None. K. Rigler: None. A. McDougall: None.