National audit results Marwan Bukhari on behalf of SGAWG.
Transcript of National audit results Marwan Bukhari on behalf of SGAWG.
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