P034 Nurse-led biologic group education clinic for patients with inflammatory arthritis: a quality improvement project

Abstract Background/Aims For individuals with persistently active inflammatory arthritis (IA) despite conventional therapy, timely escalation to biological agents enhances the likelihood of disease remission, reduces disease-related complications, and improves long-term outcomes. Mapping the patient journey within our department’s biologics service identified a delay in initiating biologic therapy as a key area for improvement. Objective: To reduce waiting times for commencing biologic therapy among patients with IA. Methods Using the Plan-Do-Study-Act (PDSA) methodology as part of the Trust’s continuous improvement programme, we implemented a service redesign targeting the education stage preceding biologic initiation. According to our local pathway, patients are required to attend a 30-minute, face-to-face biologic education appointment following clinical assessment and satisfactory pre-biologic screening. Previously, these sessions were delivered individually within a weekly clinic accommodating six patients. In March 2024, a nurse-led group biologic education clinic was introduced. Each weekly session, facilitated by an experienced Nurse Practitioner, consists of two patient groups (3-4 patients per group) organised according to the biologic class. Each 30-minute session provides information on treatment benefits, risks, side effects, administration, and monitoring requirements. Standardised clinic letter templates were developed to minimise administrative burden. Two to three individual appointments remain available per clinic for patients unsuitable for group education due to language barriers, learning disabilities, or personal preference. Audit and Evaluation: Waiting times from treatment decision to education appointment were audited before (March-April 2023) and after (March-April 2024) implementation of the group intervention. Anonymous post-session surveys assessed patients’ perceptions of session quality and confidence in their knowledge of biologic therapy. Results A total of 81 patients were included, out of which 28 patients attended the group sessions. Median waiting time from treatment decision to education appointment decreased from 46 days at baseline to 10 days following implementation. Weekly clinic capacity increased from 6 to 12-18 patients, with negligible impact on administrative workload. All patients rated the sessions as useful, interactive, and engaging, particularly appreciating opportunities for peer support. Mean scores for overall session quality and confidence in biologic knowledge were 9.85/10 and 9.42/10, respectively. Conclusion Nurse-led group biologic education clinics represent a feasible, efficient, and patient-centred approach to reducing delays in biologic initiation for IA. This model substantially improves service capacity and patient satisfaction with minimal resource implications and could be readily adopted across other rheumatology services. Disclosure T. Alcala: None. S. Voules: None. D. Alderton: None. E. Ntatsaki: None. C. Kelly: None. T. Gudu: None.