Background/Purpose: The Subspecialty Clinic Model (SCM) which seeks to allow for collaborative care and services by stratifying patients with a particular disease or need to a specialized clinic has been growing in popularity in rheumatology. This model has been shown to not only improve patient satisfaction but also patient outcomes. While the SCM is popular in other rheumatologic diseases such as lupus, it is less popular for rheumatoid arthritis. In this study, we sought to collect patients’ perspectives on a SCM for RA. To our knowledge, this is the first study to take into account patient perspectives in designing a RA subspecialty clinic.

Methods: 54 adult patients with a diagnosis of RA based on ICD-10 diagnostic codes were surveyed at an outpatient rheumatology clinic. Participants were asked to complete a survey rating their interest (0-10, with 10 being the most desired) in having a service (pharmacist, nurse, physical therapist, hand therapist, orthopedics, podiatrist, psychiatrist, cardiologist, support group, xray, ultrasound), the time (0, 5, 15, 20, 30, 45, 60 minutes) they were willing to have with said services, whether they would agree to be billed for the services, how often they would attend a clinic under the SCM, and if they would transfer care to a SCM. Statistical measures of location were used to analyze the data.

Results: Among those surveyed, 88% of respondents were interested in having at least one of the services that were described. Almost all participants (94%) expressed interest in getting an annual report. Having a psychiatrist help improve pain perception was the least popular service, but over half the respondents still expressed interest (62%). Among respondents who were interested in a service, the service that evoked the strongest interest was hand physical therapy (average of 8.19). The service that evoked the weakest response was a support group (average of 4.74). Participants were willing to spend the most time with a physical therapist (average 28 minutes) and the least time with a pharmacist and nurse (average 10 minutes). More than 75% of respondents were willing to be billed for xrays, ultrasound, physical therapy, hand therapy, and orthopedics. Less than 60% of respondents were willing to be billed for the remaining services. 74% of participants reported that they would attend a clinic under the SCM at least yearly and 50% were willing to transfer their care in order to access these services.

Conclusion: Patient perspective and satisfaction has recently become a focus in medicine as it often positively correlates to patient outcomes. The response from our participants were strongly in favor of the SCM for rheumatoid arthritis. This indicates that movement to the SCM may be advisable.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/in-favor-of-the-subspecialty-clinic-model-for-rheumatoid-arthritis/