POS0347-PARE A NATIONAL SURVEY OF RHEUMATOLOGY TELEPHONE ADVICE LINE SUPPORT IN THE UNITED KINGDOM: USER PERSPECTIVES

Background: Telephone advicelines are available in the majority of NHS rheumatology departments so that patients can speak with a member of the rheumatology team between appointments to provide support and guidance on aspects of their care (BSR 2020). For people contacting the service with heightened disease activity or medication issues, there is a recommended response time of 1-2 days (NICE 2020). The demand for rheumatology telephone advicelines is high, influenced by reconfiguration of services post pandemic and difficulties patients face accessing primary care services. These factors coupled with the implementation of patient initiated follow up (PIFU), have increased the use of telephone adviceline services. A recent UK survey of how rheumatology telephone advicelines currently operate, identified that nurses were struggling to cope with the current demand, resulting in patients waiting longer to have their calls returned, negatively impacting on the emotional health of nurses with increased levels of stress and anxiety reported. Despite rheumatology telephone advicelines being established for the benefit of patients there has been a scarcity of research on patients' experiences, and the aim of this survey was to explore the experiences and expectations people with RA/inflammatory arthritis using telephone adviceline services. Objectives: An online questionnaire was developed by NRAS with people with rheumatoid arthritis and with input from health professional stakeholders including rheumatology nurses and a rheumatologist. The survey was aimed at people who had used an NHS rheumatology telephone adviceline service. Potential participants accessed an electronic link to an invitation letter, and a questionnaire. Methods: The survey was advertised via the National Rheumatoid Arthritis Society to its member and non-member communities through social media. This survey was conducted between August and September 2024. NRAS collaborated with Prof. Sarah Ryan and Prof. Sam Hider and nursing team at MPFH and the Haywood Hospital, Stoke on Trent. The survey collected data on participants' demographics, how advicelines function, experiences of using the adviceline and how services could be improved. Data was collected via an electronic questionnaire using Microsoft forms. The survey consisted of 3 sections including demographic data, how telephone advice lines services function and experiences of using a rheumatology telephone advice line. There was also a free text section asking participants to comment on how rheumatology telephone advice line services could be improved. The free text comments were read and coded thematically by members of Prof. Ryan's team. Connected themes were then clustered together and further refined until the main themes were agreed upon. Results: A total of 1423 participants completed the survey. The majority were female, (n=1338, 94%), white (n=1455, 95%) had rheumatoid arthritis (n=1288,91%), with a disease duration of over 6 years (n=975,68%) and aged between 61-80 years (n=849, 56%). Most services were automated (n=1273,85%), although participants said they would prefer to speak to someone directly (n=889,59%). The main reasons for contacting the advice line were experiencing a flare (n=946,66%), pain (n=876, 61) and concerns about medicines (n=863, 61%). Most participants found the advice given to be ‘helpful to very helpful' (n=847,59%) and were ‘confident to very confident' (n-866) that they could implement the advice given. 839 (56%) calls were returned within 48 hours. There were 665 free text responses regarding how telephone advice lines services could be improved and these focused on three main areas; •increasing availability •improving response times •employing more nurses Conclusion: There is an increasing and high demand for rheumatology advicelines services by patients with inflammatory arthritis due to the difficulties many patients are currently experiencing trying to contact their team or their GP for help with disease management and symptom control, and potentially also due to the numbers of patients being moved onto Patient Initiated Follow-up pathways (PIFU). Having a robust telephone adviceline service that can respond quickly to patient need has become more important due to the number and complexity of drugs, making non specialists less able to confidently provide advice. If callers experiencing disease side effects and obtain the therapy management support they need, then a large proportion do not go on to search for further healthcare. This survey, which is the first national survey of RA patients using NHS rheumatology telephone advice line services across the UK, has highlighted the following key messages: There is an increasing and high demand for rheumatology advicelines services by patients with RA/inflammatory arthritis. Services need to be redesigned to improve response times. Patients require access to additional self-management resources. Therefore, different methods of supporting patients is required including redesigning services, sharing with patients the likely response times, reviewing accessibility and signposting patients to other trusted and evidence-based sources of self-management support. A recent evaluation of an online learning module to support the self-management of pain and flares in people with rheumatoid arthritis showed an increase in both knowledge and confidence post module in managing symptoms and people welcomed access to information from a trusted source which they had not received from the NHS. REFERENCES: NIL . Acknowledgements: NIL . Disclosure of Interests: Ailsa Bosworth NRAS has received educational grants from a number of pharmaceutical companies but not in relation to this abstract. Sarah Ryan: None declared. Samantha Hider: None declared. Sally Matthews: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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