Article Text

OP0158-PARE Lack of Patient Public Engagement at Introduction of a New Model of Community Dmard Monitoring
  1. L. Ball1,
  2. J. Kirk2,
  3. T. Mirando2,
  4. E. Edwards2,
  5. B. Colaco2
  1. 1Rheumatology
  2. 2Central Middlesex Hospital, North West London NHS Trust, London, United Kingdom


Background Our local clinical commissioning group (LCCG) introduced a protocol for DMARD blood and clinical monitoring by GPs for stable inflammatory arthritis (excluding those on biologics). This reduces patient contact with the secondary care team to an annual review visit, with 3-5 interim primary care consultations over the course of a year. The LCCG expects to reduce hospital attendance for 1500 patients who are reviewed twice a year, thus reducing hospital visits by 3000 per year.

Objectives The CMH patient self-help group considered that this change in policy may improve patient safety. We wished to examine patient views on any other impact (positive or negative) it may have on continuity and quality of care and their perception of the level of patient public engagement.

Methods A patient questionnaire was constructed to assess the patient's views on the change in protocol and the impact they felt it would have on their continuity and quality of care. The questionnaire was designed on survey monkey and consisted of 10 questions. The Likert Scale of scoring was implemented to answer each question. The questionnaire was emailed to all registered patient members under the care of the Rheumatology Unit at Central Middlesex Hospital. Of 370 recipients 130 opened the email, 65 reviewed the questionnaire and 46 responded in confidence via Survey Monkey. Patients were on one of four main DMARDS used (methotrexate, azathioprine, hydroxychloquine and sulfasalazine). Details of methods and all data will be published on the poster.

Table 1.

Patient responses to perceived impact on patient care with implementation of new protocol

Key resultsPPE: 86.96% of respondents (n=40) had not previously heard about the new policy and a further question regarding Patient Public Engagement noted 78.72% (n=37) had felt disenfranchised.

Conclusions Patient responses to the questionnaire, regarding the impact of a well-intentioned GP led DMARD safety monitoring initiative, highlighted concerns about potential loss of quality and continuity of care. Surprisingly however, the perception that patient safety may be compromised imposes a responsibility to re-audit this process. The patient group felt disenfranchised by a lack of Patient Public Engagement in the development of this new protocol.

Disclosure of Interest None declared

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