Early Identification of Axial Spondyloarthritis

2018 SPARTAN Annual Meeting, “Unmet Needs” Breakout Session

Session leaders:
Abhijeet Danve, MD, Yale New Haven Hospital, New Haven, CT, abhijeet.danve(at)yale.edu
Atul Deodhar, MD, Oregon Health Sciences University, Portland, OR, deodhara(at)ohsu.edu

Background:
Early identification of axial spondyloarthritis among patients with chronic back pain is one of the biggest unmet needs in North America. Although axSpA is at least as prevalent as RA, it is underdiagnosed and missed, partly due to lack of referral of these patients to rheumatologists. At the same time, rheumatologists cannot see all back-pain patients. Timely referral of appropriately preselected patients to rheumatologists should lead to early diagnosis, and can positively affect patient outcomes.

Objective:
To develop a feasible and practical strategy to improve early identification of axSpA among patients with chronic back pain by a targeted educational/advertising campaign directed at primary care and chiropractic providers and using SPARTAN members’ expertise.

Plan of the Breakout Session:
This breakout session will consist of two short plenary talks, presentation of the proposal for a new SPARTAN initiative to improve referrals, followed by question and answer session and discussion.

• Plenary Talk 1: The current state of axSpA diagnosis and referral in the USA (7 minutes): Abhijeet Danve
• Plenary Talk 2: On-going studies in the USA on early recognition and appropriate referral of axial spondyloarthritis (8 minutes): Atul Deodhar
• Proposal for a new SPARTAN Initiative for improving referrals of suspected axial spondyloarthritis patients: (Presentation of the proposal – 5 minutes by Atul Deodhar, Q&A and Discussion 30 minutes)
  We propose a targeted educational/advertising campaign directed at primary care and chiropractors in select cities in the USA where SPARTAN members practice, to improve referrals of back pain patients with suspected axSpA to local members of SPARTAN. The educational / advertising campaign will consist of developing a one page informational sheet on axial spondyloarthritis, and a referral strategy. It will use traditional methods (sending postal mail) and digital social media (Facebook, Tweets). The breakout group discussions will focus on development of this educational/advertising campaign: how to develop the materials, how to distribute them, whom to target, and how to target. We will aim to measure the impact of this intervention in the form of number of new referrals for suspected axSpA to selected SPARTAN members before and after the education/advertising campaign. Early identification and expert treatment of axSpA should not only help filling this huge unmet need, but this will also help enrolling patients into CLASSIC study, SPARTAN patient registry and/or clinical trials (SPARTAN’s CTC initiative).
• Summary and development of action items (10 min)

Potential outcomes:
This new SPARTAN intervention should improve the early identification of axSpA among chronic back pain patients. This should also improve enrollment in CLASSIC study and SPARTAN registry.

References:
https://www.ncbi.nlm.nih.gov/pubmed/26987341
https://www.ncbi.nlm.nih.gov/pubmed/25946983