PROM, Rheumatic Disease
Conditions
Keywords
digital tools
Brief summary
The purpose of this study is to evaluate the patient engagement with digital tools for diagnosis and monitoring of disease in rheumatology services
Detailed description
The investigators plan to undertake a mixed methods study to investigate a digital algorithm to potentially inform triage of new patient referral to rheumatology services, as well as to inform follow up review schedules. Current practice at out hospital is to ask all newly referred patients to complete a pre-appointment digital questionnaire prior to their clinic visit. Patients who need follow up are then routinely invited to continue to return interval questionnaires related to their symptoms between clinic visits. The investigators believe that the questionnaire responses could enable appropriate (and safe) allocation to a particular clinic (e.g. urgent early arthritis clinic or general rheumatology clinic for a new referral), or define an appropriate clinic follow up interval for a repeat visit for patients with a rheumatic disease. Our study aims to evaluate these questionnaires using data collected from routine clinical practice, as well a series of semi-structured interviews with service users.
Interventions
OTHERQuestionnaire
Questionnaires completed as part of routine care - this is an observational study
OTHERSemi-structured interview
Semi-structured interview to review factors involved in patients engaging or not-engaging with the digital tools
Sponsors
Guy's and St Thomas' NHS Foundation Trust
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
quantitative phase: * Aged 18 years and above * Able to complete the questionnaire in English 1\. New patient pre-appointment questionnaires * Referred as a new patient to the rheumatology outpatient department at Guys and St Thomas' Trust between 01/01/2019 to 01/10/2023 and sent a digital pre-appointment questionnaire * Electronic patient notes recorded between 01/01/2019 to 01/10/2024 2\. Follow up patients PROM questionnaires * Patients under followup of the rheumatology department at Guys and St Thomas' Trust with a diagnosis of rheumatoid arthritis, psoriatic arthritis or axial spondyloarthropathy who have been added to the remote monitoring program between 01/01/2019 to 01/10/2023 * Electronic patient notes recorded between 01/01/2019 to 01/10/2024 Inclusion criteria: qualitative phase: * Aged 18 years and above 1\. New patient pre-appointment questionnaires * Referred as a new patient to the rheumatology outpatient department at Guys and St Thomas' Trust between 01/01/2019 to 01/10/2023 and sent a digital pre-appointment questionnaire * Able to communicate in English or any language offered for audio interpreting by the LanguageLine service 2\. Follow up patients PROM questionnaires * Patients under followup of the rheumatology department at Guys and St Thomas' Trust with a diagnosis of rheumatoid arthritis, psoriatic arthritis or axial spondyloarthropathy who have been added to the remote monitoring program between 01/01/2019 to 01/10/2023 * Able to communicate in English or any language offered for audio interpreting by the LanguageLine service
Exclusion criteria
quantitative phase: * Under 18 years of age * Unable to complete study questionnaires
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with a non-inflammatory diagnosis | 3 years | Clinician assessed diagnosis as categorised into inflammatory \[e.g. rheumatoid arthritis\] or non-inflammatory \[e.g osteoarthritis or fibromyalgia\] |
| Clinician assessed DAS-28 score for patients with rheumatoid arthritis | 3 years | Clinician assessment of disease activity at next follow-up visit for remote monitoring questionnaires |
| Clinician assessed PsARC score for patients with psoriatic arthritis | 3 years | Clinician assessment of disease activity at next follow-up visit for remote monitoring questionnaires |
| Rate of response to digital questionnaires | 3 years | Proportion of patients completing the new patient pre-appointment and follow-up remote monitoring questionnaires. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PHQ8 scores in new patients completing pre-appointment questionnaires | 3 years | To estimate the prevalence of depression in new referrals to the rheumatology service. Score range 0 to 24, with higher score indicating more severe depression |
| GAD7 scores in new patients completing pre-appointment questionnaires | 3 years | To estimate the prevalence of anxiety in new referrals to the rheumatology service. Score range 0 to 21, with higher score indicating more severe anxiety |
Contacts
Primary ContactNikita Arumalla, MBBS, BSc
Outcome results
None listed