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. 2023 Oct;43(10):1905-1911.
doi: 10.1007/s00296-023-05392-5. Epub 2023 Jul 24.

Student-led clinics and ePROs to accelerate diagnosis and treatment of patients with axial spondyloarthritis: results from a prospective pilot study

Sophie von Rohr #  1   2 , Johannes Knitza #  1   2   3 , Manuel Grahammer  4   5 , Marc Schmalzing  6 , Sebastian Kuhn  7 , Georg Schett  1   2 , Andreas Ramming  1   2 , Hannah Labinsky  8   9   10
Affiliations

Student-led clinics and ePROs to accelerate diagnosis and treatment of patients with axial spondyloarthritis: results from a prospective pilot study

Sophie von Rohr et al. Rheumatol Int. 2023 Oct.

Abstract

We aimed to investigate (1) student-led clinics and (2) electronic patient-reported outcomes (ePROs) to accelerate diagnosis and treatment of patients with axial spondyloarthritis (axSpA). Patients with suspected axSpA completed an initial student-led clinic visit (T-1) prior to their planned actual rheumatologist visit (T0). Acceleration of patient appointment and NSAID therapy start, availability of diagnostic findings, and treatment response at T0 were evaluated. Beginning at T-1, patients completed electronic BASDAI questionnaires every 2 weeks. Concordance of paper-based and electronic BASDAI was evaluated. Patient acceptance of ePRO reporting and student-led clinics was measured using the net promoter score (NPS). 17/36 (47.2%) included patients were diagnosed with axSpA. Student-led clinics (T-1) significantly accelerated patient appointments by more than 2 months (T0, T-1, p < 0.0001) and axSpA guideline-conform NSAID treatment (p < 0.0001). At T0, diagnostic workup was completed for all patients and 7/17 (41.2%) axSpA patients presented with a clinically important improvement or were in remission. 34/36 (94.4%) patients completed at least 80% of the ePROs between T-1 and T0. Electronic and paper-administered BASDAI correlated well (r = 0.8 p < 0.0001). Student-led clinics and ePROs were well accepted by patients with NPS scores of + 62.0% (mean ± SD 9.2/10.0 ± 0.9) and + 30.5% (mean ± SD 8.0/10.0 ± 1.7), respectively. In conclusion, student-led clinics and ePRO monitoring were well accepted, accelerated diagnostic workup and treatment in patients with axSpA.

Keywords: Axial spondyloarthritis; Diagnostic delay; Electronic patient-reported outcome; Student; axSpA; ePRO.

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Conflict of interest statement

JK has received research support from and has received consulting/speaker’s fees from Novartis Pharma GmbH and ABATON. MG is founder and shareholder of ABATON GmbH. SK is founder and shareholder of MED.digital GmbH. The other authors have disclosed no conflicts of interest.

Figures

Fig. 1
Fig. 1
Availability of medical data at T-1 and T0. Total percentage of available results and whether result were available (green) or not (orange) at time points T-1 (student consultation) and T0 (physician consultation). P, patient; SA, structured anamnesis; HLA, HLA-B27; avail, available
Fig. 2
Fig. 2
Early initiation of axSpA therapy. A The therapies of the 17 axSpA patients at the time before T-1 and before T0 are shown. B ASDAS-CRP scores of all axSpA patients and C of all newly NSAID-treated axSpA patients at T-1 and T0 are demonstrated. Statistical significance was assessed using the Mann–Whitney U test
See this image and copyright information in PMC

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