SAT0345 Quality indicators in the care of psoriatic arthritis
Authors: P. Helliwell, G. Favier, D. Gladman, E. Soriano, B. Kirkham, L. Coates, L. Puig, W.-H. Boehncke, D. Thaci
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> In 2016, members of GRAPPA in collaboration with KPMG LLP (UK) conducted a study to benchmark care in psoriatic arthritis (PsA). Challenges in the care of patients with PsA were identified but a key finding was that centres do not usually have processes in place to measure the impact of improved quality of care.<sup>1</sup> <h3>Objectives</h3> To identify quality of care indicators to enable PsA caregivers to assess and monitor the outcomes of specific initiatives aimed at improving care in four focus areas. The focus areas are aligned to key patient pathway challenges: 1) Shorten time to diagnosis, 2) Improve multi-disciplinary collaboration, 3) Optimise disease management and 4) Improve disease monitoring. <h3>Methods</h3> 1. Structured review literature to obtain a longlist of 100 potential indicators across 4 focus areas. Search strategy used specific terms related to quality measures in PsA, adjacent and other chronic diseases. 80+publications were reviewed and rated based on relevance to four focus areas. 2. Survey expert rheumatologists and dermatologists representative of different healthcare systems to review the longlist and identify the most meaningful and feasible indicators for use in day to day practice. 3. Consensus discussion among the experts to identify shortlist of indicators based on pre-defined selection criteria. Key criteria for the Indicators were:<sup>1</sup> support improvement of patient care<sup>2</sup> evidence-based,<sup>3</sup> measurable, and<sup>4</sup> feasible. 4. Electronic group discussion among the experts to refine definitions of shortlisted indicators and targets. <h3>Results</h3> The expert group arrived at a consensus with a shortlist of 8 quality indicators across each focus area. Domain (Indicator, Target). 1. <i>Shorten time to diagno</i>sis (a) Average duration from presentation to HCP to confirmed PsA diagnosis. Less than 6 months<sup>2</sup> (b)% of patients with Psoriasis who receive a PsA screening test Annually<sup>3</sup>). 2. <i>Improve multidisciplinary collaboration</i> (a) Multidisciplinary PsA assessment is available (Y/N)<sup>4</sup> (b) Does the centre provide suitable training for HCPs, nurses etc. to increase awareness of PsA disease symptoms (Y/N)<sup>5</sup> 3<i>. Optimise disease management</i> (a) Average number of PsA evaluations done by HCP per patient in a year<sup>6</sup>1–2 annually (b)% PsA patients on whom T2T strategy is applied<sup>7</sup> 4. <i>Improve disease monitoring</i> (a)% of PsA patients who received full disease assessment for co-morbidities, e.g. co-morbidity index at least once every year<sup>8</sup> (b) Availability of short-term unscheduled appointments (Y/N)?<sup>9</sup> Max. 2 weeks. <h3>Conclusions</h3> 8 quality indicators in 4 areas of practice have been defined. The respective targets are evidence based, feasible, measurable and meaningful for patients. <h3>References</h3> [1] Favier, et al. J Rheumatol2017;44(5):674–678. [2] Haroon, et al. Ann Rheum Dis2015;74(6):1045–50. [3] NICE, Psoriasis: the assessment and management of psoriasis2017. [4] Urruticoechea-Arana, et al. Reumatol Clin2017;24:S1699–258X(17) 30183–3. [5] Betteridge, et al. J Eur Acad Dermatol Venereol2016;30(4):576–585. [6] Combeet al. Ann Rheum Dis2016;0:1–12. [7] Smolen, et al. Ann Rheum Dis2014;73(1):6–16. [8] Miedany, et al. Rheumatol Orthop Med2017;2(2):1–7. [9] Lebwohl, et al. Am J Clin Dermatol2016;17:87–97. <h3>Acknowledgements</h3> This study was funded by Abbvie <h3>Disclosure of Interest</h3> None declared