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Patient- and clinician-reported outcomes for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis

Patient- and clinician-reported outcomes for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis
Patient- and clinician-reported outcomes for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis
Objectives. Our aim was to conduct a national audit assessing the impact and experience of early management of inflammatory arthritis by English and Welsh rheumatology units. The audit enables rheumatology services to measure for the first time their performance, patient outcomes and experience, benchmarked to regional and national comparators. Methods. All individuals >16 years of age presenting to English and Welsh rheumatology services with suspected new-onset inflammatory arthritis were included in the audit. Clinician- and patient-derived outcome and patient-reported experience measures were collected. Results. Data are presented for the 6354 patients recruited from 1 February 2014 to 31 January 2015. Ninety-seven per cent of English and Welsh trusts participated. At the first specialist assessment, the 28-joint DAS (DAS28) was calculated for 2659 (91%) RA patients [mean DAS28 was 5.0 and mean Rheumatoid Arthritis Impact of Disease (RAID) score was 5.6]. After 3 months of specialist care, the mean DAS28 was 3.5 and slightly >60% achieved a meaningful DAS28 reduction. The average RAID score and reduction in RAID score were 3.6 and 2.4, respectively. Of the working patients ages 16–65 years providing data, 7, 5, 16 and 37% reported that they were unable to work, needed frequent time off work, occasionally and rarely needed time off work due to their arthritis, respectively; only 42% reported being asked about their work. Seventy-eight per cent of RA patients providing data agreed with the statement ‘Overall in the last 3 months I have had a good experience of care for my arthritis’; <2% disagreed. Conclusion. This audit demonstrates that most RA patients have severe disease at the time of presentation to rheumatology services and that a significant number continue to have high disease activity after 3 months of specialist care. There is a clear need for the National Health Service to develop better systems for capturing, coding and integrating information from outpatient clinics, including measures of patient experience and outcome and measures of ability to work.
1462-0324
231-238
Ledingham, J.M.
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Snowden, N.
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Rivett, A.
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Galloway, James
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Ide, Zoe
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Firth, Jill
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MacPhie, E.
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Kandala, N.
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Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Rowe, I.
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Ledingham, J.M.
a4e0467a-d340-4aa0-affb-096a03c02c7a
Snowden, N.
828f07f1-8d47-43ae-a40a-23161a6043eb
Rivett, A.
cb3958d6-d479-4e6b-bdc0-be61bdd87dcd
Galloway, James
acca67a9-d8e2-4bee-8806-2f3859c0adf3
Ide, Zoe
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Firth, Jill
f3523c08-253b-498a-8c09-2c21dae5e193
MacPhie, E.
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Kandala, N.
3e48fb8b-cd1d-4a57-b840-d80e193db86f
Dennison, Elaine
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Rowe, I.
ac3ceec2-f8f8-4534-a93c-2b9a1b54be28

Ledingham, J.M., Snowden, N., Rivett, A., Galloway, James, Ide, Zoe, Firth, Jill, MacPhie, E., Kandala, N., Dennison, Elaine and Rowe, I. (2017) Patient- and clinician-reported outcomes for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis. Rheumatology, 56 (2), 231-238. (doi:10.1093/rheumatology/kew309).

Record type: Article

Abstract

Objectives. Our aim was to conduct a national audit assessing the impact and experience of early management of inflammatory arthritis by English and Welsh rheumatology units. The audit enables rheumatology services to measure for the first time their performance, patient outcomes and experience, benchmarked to regional and national comparators. Methods. All individuals >16 years of age presenting to English and Welsh rheumatology services with suspected new-onset inflammatory arthritis were included in the audit. Clinician- and patient-derived outcome and patient-reported experience measures were collected. Results. Data are presented for the 6354 patients recruited from 1 February 2014 to 31 January 2015. Ninety-seven per cent of English and Welsh trusts participated. At the first specialist assessment, the 28-joint DAS (DAS28) was calculated for 2659 (91%) RA patients [mean DAS28 was 5.0 and mean Rheumatoid Arthritis Impact of Disease (RAID) score was 5.6]. After 3 months of specialist care, the mean DAS28 was 3.5 and slightly >60% achieved a meaningful DAS28 reduction. The average RAID score and reduction in RAID score were 3.6 and 2.4, respectively. Of the working patients ages 16–65 years providing data, 7, 5, 16 and 37% reported that they were unable to work, needed frequent time off work, occasionally and rarely needed time off work due to their arthritis, respectively; only 42% reported being asked about their work. Seventy-eight per cent of RA patients providing data agreed with the statement ‘Overall in the last 3 months I have had a good experience of care for my arthritis’; <2% disagreed. Conclusion. This audit demonstrates that most RA patients have severe disease at the time of presentation to rheumatology services and that a significant number continue to have high disease activity after 3 months of specialist care. There is a clear need for the National Health Service to develop better systems for capturing, coding and integrating information from outpatient clinics, including measures of patient experience and outcome and measures of ability to work.

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rervised outcome paper - main text tracked changes v2 - Accepted Manuscript
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Accepted/In Press date: 15 July 2016
e-pub ahead of print date: 1 October 2016
Published date: February 2017
Organisations: Human Development & Health, MRC Life-Course Epidemiology Unit

Identifiers

Local EPrints ID: 406561
URI: http://eprints.soton.ac.uk/id/eprint/406561
ISSN: 1462-0324
PURE UUID: 778680c5-5692-43b5-899a-71afe66f66dc
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 18 Mar 2017 02:22
Last modified: 16 Mar 2024 05:07

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Contributors

Author: J.M. Ledingham
Author: N. Snowden
Author: A. Rivett
Author: James Galloway
Author: Zoe Ide
Author: Jill Firth
Author: E. MacPhie
Author: N. Kandala
Author: Elaine Dennison ORCID iD
Author: I. Rowe

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