Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr;44(4):663-673.
doi: 10.1007/s00296-023-05522-z. Epub 2024 Jan 30.

Pre-assessment of patients with suspected axial spondyloarthritis combining student-led clinics and telemedicine: a qualitative study

Katharina Boy  1 , Sophie von Rohr  2 , Susann May  3 , Sebastian Kuhn  4 , Georg Schett  2 , Hannah Labinsky #  2   5 , Johannes Knitza #  2   4   6 , Felix Muehlensiepen #  3   6
Affiliations

Pre-assessment of patients with suspected axial spondyloarthritis combining student-led clinics and telemedicine: a qualitative study

Katharina Boy et al. Rheumatol Int. 2024 Apr.

Abstract

Objective: Patients referred to rheumatologists are currently facing months of inefficient waiting time due to the increasing demand and rising workforce shortage. We piloted a pre-assessment of patients with suspected axial spondyloarthritis (axSpA) combining student-led clinics and telemedicine (symptom assessment, symptom monitoring and at-home capillary self-sampling) to improve access to rheumatology care. The aim of this study was to explore (1) current challenges accessing axSpA care and (2) patients' first-hand experiences.

Methods: Embedded within a clinical trial, this study was based on qualitative interviews with patients with suspected axSpA (n = 20). Data was analysed via qualitative content analysis.

Results: Student-led clinics were perceived as high-quality care, comparable to conventional rheumatologist-led visits. Patients expressed that their interactions with the students instilled a sense of trust. History-taking and examinations were perceived as comprehensive and meticulous. Telehealth tools were seen as empowering, offering immediate and continuous access to symptom assessment at home. Patients reported a lack of specificity of the electronic questionnaires, impeding accurate responses. Patients requested a comments area to supplement questionnaire responses. Some patients reported receiving help to complete the blood collection.

Conclusion: Patients' access to rheumatology care is becoming increasingly burdensome. Pre-assessment including student-led clinics and telemedicine was highly accepted by patients. Patient interviews provided valuable in-depth feedback to improve the piloted patient pathway.

Keywords: Diagnosis; Diagnostic delay; Rheumatology; Self-sampling; Symptom checkers; Telemedicine; eHealth.

PubMed Disclaimer

Conflict of interest statement

JK has received research support from and has received consulting/speaker’s fees from Novartis Pharma GmbH and ABATON. SK is founder and shareholder of MED.digital GmbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Overview of the piloted patient pathway and traditional patient pathway
Fig. 2
Fig. 2
Benefits of the new care model from the patient’s perspective
Fig. 3
Fig. 3
Limitations of the new care model from the patient’s perspective
See this image and copyright information in PMC

References

    1. Bohn R, Cooney M, Deodhar A, Curtis JR, Golembesky A. Incidence and prevalence of axial spondyloarthritis: methodologic challenges and gaps in the literature. Clin Exp Rheumatol. 2018;36(2):263–274. - PubMed
    1. Fuchs F, Morf H, Mohn J, Mühlensiepen F, Ignatyev Y, Bohr D, et al. Diagnostic delay stages and pre-diagnostic treatment in patients with suspected rheumatic diseases before special care consultation: results of a multicenter-based study. Rheumatol Int. 2023;43(3):495–502. doi: 10.1007/s00296-022-05223-z. - DOI - PMC - PubMed
    1. Redeker I, Callhoff J, Hoffmann F, Haibel H, Sieper J, Zink A, Poddubnyy D. Determinants of diagnostic delay in axial spondyloarthritis: an analysis based on linked claims and patient-reported survey data. Rheumatology (Oxford) 2019;58(9):1634–1638. doi: 10.1093/rheumatology/kez090. - DOI - PubMed
    1. Garrido-Cumbrera M, Navarro-Compán V, Bundy C, Mahapatra R, Makri S, Correa-Fernández J, et al. Identifying parameters associated with delayed diagnosis in axial spondyloarthritis: data from the European map of axial spondyloarthritis. Rheumatology (Oxford) 2022;61(2):705–712. doi: 10.1093/rheumatology/keab369. - DOI - PMC - PubMed
    1. Seo MR, Baek HL, Yoon HH, Ryu HJ, Choi HJ, Baek HJ, Ko KP. Delayed diagnosis is linked to worse outcomes and unfavourable treatment responses in patients with axial spondyloarthritis. Clin Rheumatol. 2015;34(8):1397–1405. doi: 10.1007/s10067-014-2768-y. - DOI - PubMed