Midland Rheumatology Society



Midland Rheumatology Society

Annual General Meeting

Friday 11th October 2013

Keele Hall, Keele University

Staffordshire, ST5 5BG

09.15 – 09.45 Coffee and Registration

09.45 – 10.00 Welcome and Introduction

10.00 – 10.45 Matching patients to treatments: the example of stratified care for low back pain

Professor Nadine Foster, Keele University

10.45 – 11.30 Clinical Papers

• Delays between the onset of symptoms and first rheumatology consultation in patients with rheumatoid arthritis: a national survey

Rebecca J Stack, Christian Mallen, Clare Jinks, Peter Nightingale, Karen Shaw, Sandy Herron-Marx, Rob Horne, Patrick Kiely, Chris Deighton and Karim Raza

• Prevalence and associations of posterior heel pain in the general population: an epidemiological study

Benjamin D Chatterton, Sara Muller, Edward Roddy, Stoke on Trent, Keele University

• Anti TNF therapy in Ankylosing spondylitis

-Is there any influence of ethnicity and smoking in treatment outcome?

Parthajit Das, Ash Samanta, Arumugam Moorthy, University Hospitals of Leicester NHS Trust, Leicester

11.30 – 12.00 Coffee & Poster Viewing

12.00 – 13.00 Clinical Cases

Stoke Team

13.00 – 14.00 Lunch and Poster Viewing

14.00 – 14.45 Update on gout – the commonest, but most neglected, inflammatory arthritis

Professor Michael Doherty, University of Nottingham

14.45 – 15.30 Clinical Papers

• Thrombotic Thrombocytopenic Purpura in Systemic Lupus Erythematosus: A life threatening complication requiring prompt recognition and treatment.

Adam P. Croft1,2, Vijya Rao1,2 and Caroline Gordon1,2

1. Rheumatology Research Group, Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK. 2. Lupus UK Centre for Excellence Sandwell and West Birmingham Hospitals NHS trust, West Midlands UK.

• Does intra-articular corticosteroid injection in the pre-operative period increase the risk of joint infection following hip or knee arthroplasty? A systematic review and meta-analysis

Nicolas Ellerby, Edward Roddy, Samantha Hider, John Belcher and Christian Mallen, Stoke on Trent, Keele University

• To what extent are we following NICE guidance on the switching of Biologic drugs in Rheumatoid arthritis? A regional audit of the midlands

Tim Blake, Vijay Rao, Tahir Hashmi, Nicola Erb, Jon Packham, Shireen Shaffu,

Sheila O’Reilly on behalf Regional Audit Group

15.30 – 16.00 BSR Regional Chairs' Update

Dr Jon Packham and Dr Peter Lanyon

16.00 – 16.30 Tea & Poster Viewing

16.30 – 17.00 AGM and Prize Presentation

17.00 – 17.45 Debunking Descartes

Dr Mike Jorsch, Consultant Liaison Psychiatrist

18.00 – 18.30 Drinks Reception in the Great Hall

30. Dinner in the Salvin Room

RCP approved CPD code number - 84267

This meeting has been supported by the pharmaceutical industry by purchasing exhibition stand space of which the contributions have been provided equally by

AbbVie, BMS, Chugai Pharma UK, Pfizer, UCB

CLINICAL PAPERS

1) Delays between the onset of symptoms and first rheumatology consultation in patients with rheumatoid arthritis: a national survey

Rebecca J Stack, Christian Mallen, Clare Jinks, Peter Nightingale, Karen Shaw, Sandy Herron-Marx, Rob Horne, Patrick Kiely, Chris Deighton and Karim Raza

Introduction: The first three months following the onset of rheumatoid arthritis (RA) symptoms represents a therapeutic window during which treatment is particularly effective at limiting subsequent joint damage.[pic] Therefore, it is vital that patients are seen quickly following the onset of RA symptoms. Previous research has identified that delays exists at multiple levels including patient delay in seeking help and primary care delays in making timely referrals to a rheumatologist, however, little is known about national patterns of delay. This study investigates the extent and causes of delay in assessment of patients with RA across the UK.

Methods: Ethical approval was obtained from South Birmingham Research Ethics Committee. A national cross-sectional survey of the length of time between the onset of symptoms, first seeing a GP, being referred to a rheumatologist and being seen by a rheumatologist was undertaken. Newly presenting adults with synovitis (either RA or unclassified arthritis) were recruited from secondary care rheumatology clinics from across 34 NHS Trusts in England and Scotland. Data were collected on levels of delay, as well as demographic characteristics and RA related features (rheumatoid factor and ACPA status and disease activity).

Results: 815 patients were recruited (548 female, mean age 55 years). The median time between the onset of symptoms and the patient first seeking help from a healthcare professional was 5.4 weeks; IQR 1.4 - 26.3 weeks). The median time between first seeing a healthcare professional and being referred to a rheumatologist was 6.9 weeks (IQR 2.3 – 20.3 weeks) with patients making a mean of 4 visits before being referred. The median time between being referred to secondary care and seeing a rheumatologist was 4.7 weeks (IQR 2.9 – 7.5 weeks). Overall the median time between symptom onset and seeing a rheumatologist was 26.9 weeks (IQR 14 – 66 weeks); only20% of patients were seen within the first 3 months following symptom onset. Significant differences were found between NHS Trusts for patient delay (p=0.002), primary care delay (p ................
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