Post on 01-Apr-2015
National audit results
Marwan Bukhari on behalf of SGAWG
Audit standard
• Patients with RA should be referred within twelve weeks of symptom onset
• Once referred they should be seen within six weeks
• DMARDS should be started without delay
results
• 1313 fully returned questionnaires were analyses in the period
• 890 (67%) female• 1153 (89%) caucasian
Age at onset
Age range Number %16-30 84 6.4%31-50 376 28.6%51-70 585 44.6%> 70 260 40.4%
Time to start
325 25.3%
957 74.4%
Time from disease onset to GP referral
weeks Number %0-3 137 10.54-6 209 16.17-9 119 9.2
10-12 114 8.8>12 716 55.3
Time from GP referral to hospital
weeks Number %0-3 366 28.24-6 532 41.07-9 219 16.9
10-12 89 6.9>12 90 6.9
Time from hospital to DMARD
weeks Number %0-3 634 48.94-6 236 18.27-9 122 9.4
10-12 62 4.8>12 243 18.7
Delay between hospital and DMARD
557 42.6%
751 57.4%
Cause of delay
cause N %Diagnostic uncertainty 334 59.3
Contra-indication 28 5.0Lack of follow up slots 46 8.2
other 154 27.4
101
31
58
71
91 36
175
127
181
139
153
Variation in regions
• Gender – lowest females N west (55%)– Highest females east and west midlands (75%)
• Ethnicity– Most london (49% caucasian)– Least N Ireland (100% caucasian)
Variations in age at onset
• 11 % 17-30 west midlands vs 6 % nationally• Most others similar across regions
• Region with least over 70’s is N Ireland (9.7%) vs around 20% nationally
Variation in starting DMARD
• Before 12 weeks– Best east midlands 36.4% , worst Wales 12.97%
• From hospital to starting DMARD quickest East midlands N ireland and scotland (>70% less than 3 weeks)
• slowest East and Yorkshire(>20% waiting more than 12 weeks from hospital to DMARD
Onset to referral > 12 weeks
Time from referral to seen <6 weeks
Delay in starting DMARD
Conclusions
• Average return of data
• Still not achieving national targets
• Delays from onset to referral, from referral to being seen and on start of first DMARD