POS0376 THE ROLE OF ELECTRONIC CONSULTATION IN THE EARLY DIAGNOSIS OF INFLAMMATORY ARTHROPATHIES IN A THIRD LEVEL HOSPITAL

Autor: D. V. Mendoza Mendoza, D. Ruiz-Montesinos, V. Moreira Navarrete, J. J. Pérez Venegas
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:442.2-443
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2022-eular.3066
Popis: BackgroundThe relevance of early diagnosis in rheumatic inflammatory diseases is well known. Electronic consultation (e-Consults) is a tool for communication between primary health care (PHC) and hospital care (HC) physicians in order to present the cases of patients. It has proven to resolve cases without on-site consultations and to facilitate quick access to conventional consultations.ObjectivesTo evaluate whether e-Consults is an effective tool in the early diagnosis of inflammatory arthropathiesTo evaluate whether the clinical suspicion of the rheumatologist correspond to the final diagnosis.MethodsRetrospective, observational study of all e-Consults carried out during 2021 in the hospital area Virgen Macarena. All e-Consults were carried out by means of a computer program as a clinical extension of the research project E-Hermes for the implementation of e-Consults. The analysis focused on those e-Consults in which the rheumatologist suspected rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondylarthritis (SpA) in comparison with the final diagnosis. The on-site consultations and waiting time for appointments were also analyzed.ResultsDuring 2021, the number of e-Consults received was 733. Inflammatory arthropathy was suspected in 54 (7.4%). RA was suspected in 55.9% of the cases, PsA in 17.6% and SpA in 26.5% of the cases. 67.6% of the patients were women with an average age of 53.15 (± 17.06). 87.3% were recalled for an on-site consultation. Of these, 76.5% were given a preferential appointment and 11.8% were given a regular appointment. The waiting time for the preferential appointment was 18.5 days on average and 39 days for the regular appointment.73.7% of the patients with suspected RA were women with an average age of 55.16 years (± 16.8). The reasons for consultation were: joint swelling (89.5%), polyarthralgia (5.3%) and hand pain (5.3%). The diagnosis of RA was confirmed in 47.4% of the suspected cases and only 27.7% showed no inflammatory joint pathology.83.3% of the suspected PsA cases were women with an average age of 53 years (± 12.6). Joint swelling was the most frequent reason for consultation (50%) followed by polyarthralgia, lumbar back pain and hand pain (16.7%, respectively). The diagnosis of PsA was confirmed in 33.3% of the suspected cases.55.6% of the patients with suspected SpA were men with an average age of 49 years (± 20.8). The most frequent reasons for consultation were: joint swelling (44.4%) and lumbar back pain (33%). The suspected diagnosis of SpA was confirmed in consultation in 44.4% of the patients and only 33.3% of the suspected cases showed no inflammatory pathology.After all 733 e-Consults performed in 2021, 14 patients (2%) were diagnosed with RA, 5 (0.7%) were diagnosed with PsA and y 6 (0.9%) with SpA, which means a 3.5% diagnosis of inflammatory arthropathy by means of e-Consults.The hospital area Virgen Macarena serves 481,296 inhabitants. Considering that the incidence per 100,000 patients/year is 8.3 for RA, 3.6 for PsA and 7.2 for SpA 1-2, the number of new cases expected in our area are as follows: 40 for RA, 17 for PsA and 5 for SpA. The proportion of cases diagnosed by TC were 36% for AR, 27.7% for PsA and 18.5% for SpA, corresponding to the reference population.ConclusionThe suspected diagnosis of the rheumatologist in the e-Consults was confirmed for inflammatory joint pathologies in almost half of the cases.E-Consults is a useful tool to identify inflammatory joint processes that need evaluation in an on-site consultation.E-Consults is an efficient method for the early detection of high-impact rheumatic diseases, facilitating quick access to those patients and minimizing diagnostic time.References[1]M.J. García de Yébenes et al. Rheumatoid arthritis: Epidemiology and societal and healthcare costs. Reumatol Clin Supl. 2018;14(2):3-6[2]Munoz-Fernandez S et al. Early spondyloarthritis: results from the pilot registry ESPIDEP. Clinical and experimental rheumatology. 2010;28(4):498-503Disclosure of InterestsNone declared
Databáze: OpenAIRE
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