Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
Rheumatol Int. 2023 Oct;43(10):1905-1911. doi: 10.1007/s00296-023-05392-5. Epub 2023 Jul 24.
We aimed to investigate (1) student-led clinics and (2) electronic patient-reported outcomes (ePROs) to accelerate diagnosis and treatment of patients with axial spondyloarthritis (axSpA). Patients with suspected axSpA completed an initial student-led clinic visit (T-1) prior to their planned actual rheumatologist visit (T0). Acceleration of patient appointment and NSAID therapy start, availability of diagnostic findings, and treatment response at T0 were evaluated. Beginning at T-1, patients completed electronic BASDAI questionnaires every 2 weeks. Concordance of paper-based and electronic BASDAI was evaluated. Patient acceptance of ePRO reporting and student-led clinics was measured using the net promoter score (NPS). 17/36 (47.2%) included patients were diagnosed with axSpA. Student-led clinics (T-1) significantly accelerated patient appointments by more than 2 months (T0, T-1, p < 0.0001) and axSpA guideline-conform NSAID treatment (p < 0.0001). At T0, diagnostic workup was completed for all patients and 7/17 (41.2%) axSpA patients presented with a clinically important improvement or were in remission. 34/36 (94.4%) patients completed at least 80% of the ePROs between T-1 and T0. Electronic and paper-administered BASDAI correlated well (r = 0.8 p < 0.0001). Student-led clinics and ePROs were well accepted by patients with NPS scores of + 62.0% (mean ± SD 9.2/10.0 ± 0.9) and + 30.5% (mean ± SD 8.0/10.0 ± 1.7), respectively. In conclusion, student-led clinics and ePRO monitoring were well accepted, accelerated diagnostic workup and treatment in patients with axSpA.
我们旨在研究（1）学生主导的诊所和（2）电子患者报告结局（ePRO），以加速对中轴型脊柱关节炎（axSpA）患者的诊断和治疗。疑似 axSpA 的患者在计划的实际风湿病医生就诊（T0）前完成初始的学生主导的诊所就诊（T-1）。评估患者预约和 NSAID 治疗开始的加速情况、诊断结果的可用性以及 T0 时的治疗反应。从 T-1 开始，患者每 2 周完成电子 BASDAI 问卷。评估纸质和电子 BASDAI 的一致性。使用净促进者得分（NPS）衡量患者对电子 PRO 报告和学生主导诊所的接受程度。17/36（47.2%）名纳入患者被诊断为 axSpA。学生主导的诊所（T-1）使患者预约时间提前了两个多月（T0，T-1，p<0.0001），并使 axSpA 指南一致的 NSAID 治疗提前（p<0.0001）。在 T0，所有患者都完成了诊断性检查，17/17（41.2%）axSpA 患者表现出临床显著改善或缓解。36/36（94.4%）名患者在 T-1 和 T0 之间完成了至少 80%的 ePRO。电子和纸质 BASDAI 相关性良好（r=0.8，p<0.0001）。学生主导的诊所和 ePRO 得到了患者的广泛认可，NPS 得分分别为+62.0%（平均+±SD 9.2/10.0+±0.9）和+30.5%（平均+±SD 8.0/10.0+±1.7）。总之，学生主导的诊所和 ePRO 监测得到了广泛认可，加速了 axSpA 患者的诊断性检查和治疗。
