456. Remote clinical management using electronic assessment of patients with vasculitis

Background/ Objectives: The aim of this project was to develop generalizable digital solutions to help deliver safe, efficient and effective care for patients with long-term rheumatic conditions. We have previously demonstrated that this method is feasible and acceptable to patients with rheumatoid arthritis (RA) and spondyloarthritis (AxSpA). We evaluated the outcomes of remote assessment across a further range of conditions, including vasculitis, connective tissue diseases (CTD) and psoriatic arthritis (PsA). Methods: We developed a set of online questionnaires using readily available software to conduct a remote assessment in 806 patients awaiting follow-up appointments in rheumatology (delayed as a result of the Covid 19 pandemic). The questionnaire contained measures of disease activity; patient reported outcomes; patient preferences regarding the urgency and type of appointment required; and any other recent problems or changes in medication highlighted by the patient. For vasculitis we designed a self-assessed Birmingham Vasculitis Activity Score (BVAS) and used the published ANCA associated vasculitis patient reported outcome measure (AAVPRO). The information was imported into a bespoke clinical database allowing clinicians to conduct an asynchronous assessment, integrated within our electronic health records (EHR).Report letters were sent to the patient and their general practitioner. EHRs were reviewed in a subset of patients requiring urgent in-person assessments (within 1-month) following remote assessment: disease activity assessments were compared and treatment changes evaluated, using Chi-square test to investigate for significant differences by condition. We defined “stable” disease as patients classified as in remission or partial remission, on or off immunosuppressive therapy. Results: Table 1 summarises all the patients assessed remotely, by condition, and subsequent follow-up requested. Patients with CTD (9%) or vasculitis (11%) were least likely to require a face to face appointment within 3 ...