Pos0882 screening/referral strategies for the early recognition of psa among patients with psoriasis: results of a grappa survey

Background Diagnostic delay in psoriatic arthritis (PsA) is associated with poorer outcomes, and early screening/ referral strategies are important to reduce the delay. Implementation of early screening approaches demands cooperation between rheumatologists, dermatologists and primary care providers (PCPs). Objectives To explore the experiences of dermatologists and rheumatologists in the early recognition of PsA and suggest improvements to the current shared-care model. Methods A 24-question survey addressing referral strategies was constructed within GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) and sent to all members (n=927). Questions addressed the use of screening tools, interspecialty involvement in therapeutic decision making, and suggestions for earlier recognition. Results Surveys were completed by 113 rheumatologists from 37 countries (across six continents) and 26 dermatologists from 16 countries (across 4 continents), with a mean of 21.7 ± 10.7 and 18 ± 12.3 years experience, respectively. Of dermatologists, 81% use PsA-specific screening instruments. Conversely, rheumatologists reported that only 27% of patients referred to them from all sources had been assessed with screening tools. Across both specialties, “PEST” was reported to be the most used tool. Whilst dermatologists reported that 67% ± 28% of their suspected PsA cases were confirmed, rheumatologists felt ∼48% ± 24% of suspected PsA cases were confirmed. Both specialties (n=137) reported similar views regarding optimisation of the diagnostic process: 78% believed that the best approach involved combining patient-reported and physician-confirmed findings (see Figure 1A). Moreover, the education of PCPs was seen as the greatest priority to improve screening with 76% raising this as an unmet need (Figure 1B). Conclusion The survey indicated the current unmet needs in the early recognition of PsA. Accordingly, important areas to address include improving the use of validated screening instruments, increasing the education of community-based dermatologists and PCPs, and utilising a combination of patient-reported and physician-confirmed findings to identify patients with a high probability of PsA among those with psoriasis. Figure 1. Clinicians’ views on optimising early PsA recognition. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests Kaiyang Song: None declared, Louisa Webb: None declared, Lihi Eder Shareholder of: UCB, Employee of: TrialSpark, Oliver FitzGerald: None declared, Niti Goel: None declared, Philip Helliwell: None declared, Arnon Katz: None declared, Joseph F. Merola: None declared, Cheryl Rosen: None declared, Laura Coates: None declared, Denis Poddubnyy: None declared.