Background/Purpose:

Present guidelines (National Institute for Health and Care Excellence- NICE technology appraisal guidance TA143 2008 and TA233 2011; National Ankylosing Spondylitis Society 2010) on axial spondyloarthritis (AxSpA) support the management and monitoring of patients based on a pharmacological and physical measurement approach. In the UK, these patients often require multiple appointments with a variety of health professionals including Consultants, nurses and physiotherapists all reviewing different aspects of their condition.

Methods: To streamline these appointments, reduce the number of visits individuals need to make and release capacity in the consultant clinics, in 2014 we trialled a ‘one-stop shop’ approach with an experienced Advanced Rheumatology Physiotherapist leading the clinic with medical escalation and governance arrangements in place (see Figure 1). As this was a significant change in delivery of care we assessed the satisfaction of a sample of consecutive patients attending the clinic throughout a twelve month period. Patients were informed of the change in the service organisation prior to their attendance of the clinic. A validated Patient Reported Experience Measure questionnaire (PREM) (Bosworth A et al. 2015), as developed by Commissioning for Quality in Rheumatoid Arthritis (CQRA), a British multidisciplinary group of stakeholders, was used. The questionnaire comprises of 8 domains that have been evidenced as being most important to patients’ experiences of National Health Service (NHS) services.

Results: 64 patients completed the questionnaire (mean age 51.6 ± SD11.7; M 58/64, 87.5%). Most of the patients (46/64, 71.9%) had a disease duration of more 10 years, with approximately 50% on biologics. Percentage of patients who answered ‘strongly agreed’ or ‘agreed’ for the overall satisfaction of the service was 100% (73.4% and 26.6% respectively). The specific domains results are shown in the table.  

Conclusion: Our study suggested that overall patients were satisfied that their care was delivered by an Advanced Physiotherapist. This could present significant improvements in cost and quality of care delivered to this patient group. Although all areas scored highly for satisfaction, some domains identified areas for potential improvement within the service. These will be reviewed after further evaluation with a wider sample population. .