E040 Evaluating patient-initiated follow-up pathway in rheumatology: a service evaluation of patient experience and engagement in self-management

Abstract Background/Aims Patient initiated follow-up (PIFU) has been introduced across the NHS as part of the elective recovery plan to improve efficiency and promote person-centred care. In rheumatology, PIFU supports patient autonomy and optimises clinic capacity. Evaluating its impact and patient satisfaction is vital to ensure safe, effective and patient-informed implementation. This service evaluation explored patient understanding, confidence and experience with the rheumatology PIFU model as part of ongoing patient involvement in service development. Methods An electronic survey was distributed to 100 patients enrolled in the PIFU pathway, with 68 responses received (68%). A Likert-type scale was used to assess response to questions on PIFU experience. Quantitative data were analysed, and qualitative responses were thematically analysed to identify key patterns in patient experience. Results Of the 68 respondents, 34 (50%) were female and 59 (87%) were aged over 55 years. The primary diagnosis was rheumatoid arthritis (48, 70%), followed by psoriatic arthritis (12, 18%). For confidence in detecting a disease flare, the results showed that 81% of respondents felt very or extremely confident, reflecting strong self-efficacy in disease monitoring. Shared decision-making and communication were also identified as essential for maintaining trust and continuity of care. Sixty-five percent of respondents agreed or strongly agreed that they were well-informed about the PIFU process and how to contact the rheumatology department if needed; 22% were neutral, while 13% disagreed, with a small subset expressing concerns about isolation or delays in being seen. Contact rates while on PIFU were low (7, 10%), with only two contacts due to disease flare or medication side effects. Both were managed via telephone advice, and only two patients were converted to regular follow-up due to increased disease activity. Among the 61 (90%) patients who had not contacted the department, 12 (18%) were transitioned back to regular review due to treatment changes (primarily reduction of DMARDs whilst on remission, or clinician preference), reflecting evolving practice and the need for continued staff training. In terms of satisfaction, 61% of patients were satisfied or extremely satisfied with PIFU, 17 were neutral, and 10 were dissatisfied. Reasons for dissatisfaction included limited understanding of the booking process, a desire for more frequent reviews once on PIFU, and a lack of familiarity with PIFU among primary care providers. Despite these, qualitative comments were extremely positive, with patients expressing reassurance, ease of access, and appreciation for responsive care when required. Overall, patients reported positive experiences with the PIFU model, highlighting improved flexibility, accessibility, and a sense of control over their care. Conclusion Patients reported high confidence and satisfaction with the PIFU pathway, highlighting its flexibility and person-centred design. Their feedback informed service improvements, including clearer documentation of shared decision-making and enhanced education during transition to PIFU. Disclosure A. Escudero Siosi: None. N. Zabbey: None. G. MacDonald: None. A. Chan: None.