P022 Exploring the use of electronic patient reported outcome measures in the management of patients with axial spondyloarthritis

With increasing demand on the National Health Service, services are exploring strategies to maximise efficiency whilst improving quality of care and patient experience. Electronic patient reported outcome measures (ePROMs) are being used in the transformation of rheumatology services to monitor patients remotely and enable patients to be seen at the most appropriate time. We conducted a pilot to explore the use of ePROMs with our axial spondyloarthritis (Ax SpA) patients. The pilot aimed to establish i) whether patients would engage with ePROMs ii) whether the data would enable patients to be effectively managed remotely and iii) the potential impact incorporating ePROMs into a patient initiated follow up (PIFU) pathway could have on outpatient capacity.

Ax SpA patients under the care of the inflammatory back pain service at the Royal Free London NHS Foundation Trust were invited to participate in the pilot. 252 patients consented to be added to an electronic platform that generated ePROM links sent via short message service (SMS). The ePROMs included the BASDAI, spinal VAS, BASFI, ASQoL, FACIT-F and HADS. An SMS was sent to patients at initiation of the project and at 6 months. Due to platform limitations, only the BASDAI and spinal VAS scores were analysed. Patient experience was evaluated via an electronic survey at 6 months.

170 (67%) patients responded to the initial ePROMs and 107 (42%) of these patients responded at 6 months. When comparing the scores of patients that responded to both questionnaires, 41 (38%) had a stable BASDAI score and spinal VAS of below 4 and 12 (11%) had a BASDAI score and spinal VAS of 2 or below. A further 12 patients (11%) had a 50% or 2-point reduction in their BASDAI and spinal VAS to below 4 between questionnaire 1 and 2. In total, 53 patients (49%) that answered the ePROMs at 6 months had a BASDAI and spinal VAS below 4 indicating low disease activity. The majority of patients that responded to the patient experience questionnaire found it acceptable to complete the ePROMs and understood the purpose of the project and how it informed management.

The ePROM response rate dropped from 68% to 42% at 6 months and strategies to improve ePROM response rates would need to be explored. Clinician and patient engagement is essential to maximise the benefits of a remote monitoring service. This project highlights that incorporating ePROMs into a PIFU pathway could enable Ax SpA patients to be managed remotely. If deemed appropriate by the patient and clinician, patients completing ePROMS with low disease activity could access a PIFU pathway which has the potential to reduce follow up appointments, increase clinic capacity and enable patients to access care when required.

S. Bamford: None. H. Tahir: None.