68 participants (30 GPs and 38 GP residents) were included, of which 19 received education on SpA. A significantly higher proportion of GPs from the intervention group referred patients to the rheumatologist compared with the control group after education. Furthermore, for the intervention group, following education on SpA symptoms there was an >40% improvement in referral for axial and peripheral SpA from GPs. This work suggests that educational initiatives to improve referral and recognition of patients suspected for SpA should be developed and supported.
Large scale observational study of 141 GPs. Demonstrated a lack of confidence of GPs in differentiating inflammatory back pain, with most (87%) reporting seeing patients 3 times before attempting to make a diagnosis of inflammatory back pain. Just 5% rated themselves as “very confident” at discriminating inflammatory back pain. 64% were not aware of their existing local specialist axial SpA service. Most agreed that inflammatory back pain patients should be referred to a rheumatologist (95%) with a minority suggesting orthopaedics (5%). GPs felt their diagnostic skills could be improved by practical sessions (57%), referral pathways (69%) and electronic updates (24%), with teaching meetings (77%) preferred to digital forms of education (30%).
Preliminary exploratory analysis of unique EHR dataset of Salford axial SpA patients. Followed the journey of 10 patients with time to diagnosis of axial SpA ≥ 5 years. On average, patients had 15 primary care consultations (range 5-24) between first coded Axial SpA-related symptom and rheumatology referral. The abstract includes an illustration of the consultation pattern for a male patient who first presented to primary care with back pain at the age of 35. Despite a relatively typical presentation, his diagnosis was made incidentally 10 years later after an ESR was checked for unrelated reasons. He was significantly disabled in function at the point of being referred to rheumatology.
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