Axial spondyloarthritis (axial SpA) including ankylosing spondylitis (AS) has been included in the National Early Inflammatory Arthritis Audit for the first time.
The audit, conducted by the British Society for Rheumatology (BSR), is the largest of its kind. It follows the data of over 20,600 patients in England and Wales who are suspected of having early inflammatory arthritis.
It includes measurements including how long it takes for a patient to be referred from their GP, the time it takes to see a specialist and to receive treatment. Trusts and health boards are then measured against NICE’s quality standards which aim to drive up improvements.
For axial SpA (AS), the audit looked at 507 referrals, only around about 3% of the total number. Most patients started out being referred by their GP, with smaller numbers being referred through a musculoskeletal triage service, gastroenterology, ophthalmology or dermatology.
The report details that the low numbers of referrals from secondary care suggests that they may be failing to recognise inflammatory spine disease.
In contrast to both rheumatoid arthritis and mechanical back pain, the data shows axial SpA (AS) patients tended to have had their symptoms for much longer before being referred. The majority had their symptoms for between 1 and 5 years, compared to 1-3 months for the other conditions.
Ali Rivett, Chief Executive of BSR, said:
“Axial spondyloarthritis is a serious condition. We know that appropriate referral and prompt diagnosis have the potential to reduce the impact of the condition and prevent long-term spine damage.
We’re supporting trusts and health boards to look at their data and learn from others who are performing well to see where they can make improvements. We’ll be working with the rheumatology community over the coming months to help drive progress for everyone affected by early inflammatory arthritis.”
For more information about the audit, visit www.rheumatology.org.uk/neiaa-audit
Read about the NASS Back Pain Plus campaign which targets ophthalmology, gastroenterology and dermatology to increase referral into rheumatology for patients with back pain plus uveitis, inflammatory bowel disease or psoriasis. NASS are also working to reduce the delay to diagnosis with our NASS Allies partnership, and the Aspiring to Excellence quality improvement programme.