Objectives Waiting times for first appointments are a major obstacle to timely Rheumatology care. In order to improve access, a cooperative of office based Rheumatologists established an immediate access network offering brief initial assessments for patients with musculoskeletal problems.
Methods Patients were assessed at presentation in the offices and followed up after 6 months. Data regarding demographics, diagnostic accuracy, clinical parameters such as pain levels, and care at baseline and after 6 months were analysed.
Results From October 2012 to March 2013 335 patients were assessed in the 6 cooperating practices during dedicated office hours (each office opening once a week for this service). 124 patients (38%) had a symptom duration less than 3 months, for rheumatoid arthritis (RA) patients this proportion was 42%. In the 271 patients available for reassessment after 6 months, initial suspected diagnosis was confirmed in 88%. Initial tentative diagnosis of RA (60 patients) was confirmed in 93%, of spondyloarthritis (46 patients) in 83%.
At follow up, the visual analogue scale for pain in RA patients had significantly decreased from a median (IQR) of 70 (56 - 80) to a median (IQR) of 26 (20 - 42), for patients with spondyloarthritis from 50 (36 - 80) to 30 (20 - 40).
Conclusions The RAC resulted in a substantial waiting time reduction for rheumatology assessment. More than one third of the patients were seen before 3 months disease duration. Suspected diagnoses of inflammatory rheumatic diseases were correct in almost 90%. This initiative demonstrates the feasibility of a rapid access service and indicates high diagnostic accuracy in such a setting as well as the effectiveness of treatments recommended by the Rheumatologists.
Disclosure of Interest None declared