THU0358 DEVELOPMENT OF A SET OF ASAS QUALITY STANDARDS FOR ADULTS WITH AXIAL SPONDYLOARTHRITIS
Authors: Uta Kiltz, Robert B.M. Landewé, Désirée van der Heijde, Martin Rudwaleit, Maxime Dougados, Nurullah Akkoc, Annelies Boonen, Jan Brandt-Juergens, Philippe Caroon, Laure Gossec, Merryn Jongkees, Pedro Machado, Helena Marzo-Ortega, Anna Moltó, Victoria Navarro-Compán, Karin Niedermann Schneider, Percival D. Sampaio-Barros, Gleb Slobodin, Filip van den Bosch, Astrid van Tubergen, Salima van Weely, Michael Weisman, Dieter Wiek, Juergen Braun
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> There is wide variation in the management of patients with axial spondyloarthritis (axSpA) worldwide with significant unmet needs such as delayed diagnosis. A major goal of the international organization Assessment of SpondyloArthritis international Society (ASAS) is to improve quality of care and health outcomes in axSpA. One way to achieve this is to define quality standards (QS) in order to identify resources and processes which may need to be optimized. Such standards must be specific, measurable, aspirational and achievable in daily care. <h3>Objectives:</h3> To develop ASAS QS to ultimately improve the quality of care for adults with axSpA. <h3>Methods:</h3> The ASAS QS group, established in 2015, developed a step-wise approach starting with (I) an overview and open discussions resulting in a proposal for possible key areas for quality improvement. Thereafter, (II) ASAS members and invited patients discussed and commented on a provisional list via a web-based survey with the possibility to propose additional key areas for quality improvement. (III) The complete list was then evaluated by ASAS members and invited patients. (IV) Then, the ASAS QS group prioritized key areas for which quality statements and measures are to be developed, and (V) phrased QS for the most important key areas. Finally (VI), a draft version was commented on, discussed and finally agreed by the ASAS members at the Annual ASAS Meeting 2019. <h3>Results:</h3> The ASAS QS group, consisting of 20 rheumatologists, 2 physiotherapists and 2 patients, provided 34 potentially key areas for quality improvement which were commented by 140 participants (86 physicians, 42 patients). Within that process 3 new key areas were proposed and all 37 key areas for improvement were again evaluated by 120 participants (86 physicians, 29 patients). Five key areas were identified to be most important to phrase QS: referral, rheumatologic assessment, treatment, education/self-management and comorbidities. Altogether, 9 QS, each accompanied by a rationale and a measure (figure), were endorsed by ASAS. <h3>Conclusion:</h3> ASAS successfully developed the first QS set for improvement of health care provided for adults with axSpA. All QS are achievable in daily care in an optimized situation and intend to minimize variation in quality of care. It is emphasized that ASAS is well aware that all QS are ideal visions of an optimal care which may currently not be realistic in many countries. <h3>Disclouser of Interest:</h3> Uta Kiltz Grant/research support from: AbbVie, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche, and UCB., Consultant for: AbbVie, Chugai, Eli Lilly, Grünenthal, Janssen, MSD, Novartis, Pfizer, Roche, and UCB.,&nbsp;Robert B.M.&nbsp;Landewé: None declared,&nbsp;Désirée van der Heijde Consultant for: AbbVie, Amgen, Astellas, AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Daiichi, Eli-Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Takeda, Union Chimique Belge, Martin Rudwaleit Consultant for: AbbVie, BMS, Celgene, Janssen, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB Pharma, Consultant for: AbbVie, BMS, Celgene, Janssen, Eli Lilly, MSD, Novartis, Pfizer, Roche, UCB Pharma, maxime dougados Grant/research support from: Eli Lilly and Company, Pfizer, AbbVie, and UCB Pharma, Consultant for: Eli Lilly and Company, Pfizer, AbbVie, and UCB Pharma, Nurullah Akkoc: None declared, Annelies Boonen: None declared, Jan Brandt-Juergens: None declared, Philippe Caroon: None declared, Laure Gossec Grant/research support from: AbbVie, BMS, Celgene, Janssen, Lilly, MSD, Novartis-Sandoz, Pfizer, Sanofi, and UCB, Consultant for: AbbVie, Biogen, BMS, Celgene, Janssen, Lilly, MSD, Nordic Pharma, Novartis-Sandoz, Pfizer, Roche, Sanofi, and UCB, Consultant for: L Gossec has received honoraria from Celgene as investigator for this study, Merryn Jongkees: None declared, Pedro Machado Consultant for: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Speakers bureau: Abbvie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche and UCB, Helena Marzo-Ortega Grant/research support from: Janssen, Novartis and Pfizer, Consultant for: AbbVie, Celgene, Janssen, Eli-Lilly, Novartis and UCB, Speakers bureau: AbbVie, Celgene, Janssen, Eli-Lilly, Novartis and UCB, Anna Moltó: None declared, Victoria Navarro-Compán: None declared, Karin Niedermann Schneider: None declared, Percival D.&nbsp;Sampaio-Barros: None declared, Gleb Slobodin: None declared, Filip van den Bosch Consultant for: AbbVie, BMS, Galapagos, Janssen, Lilly, Merck, Novartis, Pfizer and UCB, Speakers bureau: AbbVie, BMS, Janssen, Lilly, Merck, Novartis, Pfizer and UCB., Astrid van Tubergen: None declared, Salima van Weely: None declared, Michael Weisman: None declared, Dieter Wiek: None declared, Juergen Braun Shareholder of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson &amp; Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Grant/research support from: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Consultant for: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Consultant for: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Consultant for: Abbott, Bristol Myers Squibb, Celgene, Celltrion, Chugai, Johnson &amp; Johnson, MSD, Novartis, Pfizer, Roche, UCB Pharma, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB, Speakers bureau: Abbvie (Abbott), Amgen, Baxter, Biogen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Hexal, Janssen, Lilly, Medac, MSD (Schering-Plough), Mylan, Mundipharma, Novartis, Pfizer (Wyeth, Hospira), Roche, Sanofi-Aventis and UCB, Speakers bureau:&nbsp;AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB&nbsp;