Using the international dermatology outcome measures (IDEOM) clinical framework to streamline psoriatic arthritis screening and assessment

Summary: Abstract Body: Due to challenges with psoriatic arthritis (PsA) detection and the risk of irreversible joint damage if inadequately treated, this quality improvement project aims to improve PsA screening, assessment, and rheumatology referral. Our clinical framework integrated the Psoriasis Epidemiology Screening Tool (PEST) and the 12-item Psoriatic Arthritis Impact of Disease questionnaire(PsAID-12) into the electronic medical record system in 26 dermatology clinics. Psoriasis (PsO) patients underwent PsA screening via the PEST. Those scoring ≥3 or already diagnosed with PsA completed the PsAID-12, which guides management. PsAID-12 score >4 indicates an unacceptable symptom state, prompting treatment changes or rheumatology referral1. Providers received results in real-time for review. Over 25 months, 7,609 PsO patients were seen by dermatology providers. Of the 6,398 PsO patients without a PsA diagnosis, 36.9% completed the PEST; 12.7% scored ≥3 and completed the PsAID-12. 74.9% of patients who took the PsAID-12 scored ≤4, indicating effective management. Of the 25.1% of patients scoring >4, 26.7% were referred to rheumatology. When comparing the 477 patients who took the PsAID-12 at least twice, an average baseline PsAID-12 score of 2.82 was seen compared to an average most recent score of 2.53, indicating a significant reduction (t-statistic = -3.69, p = 0.044). Of the 50 total patients who received referrals, 62% were seen by rheumatology. Our study demonstrates the feasibility of IDEOM’s clinical framework in optimizing PsA screening, assessment, and quality of care. References: 1. Grant C, Perez-Chada LM, Harrison RW, et al. Impact of disease, musculoskeletal symptoms and disease control in the CorEvitas Psoriasis Registry. Clin Exp Dermatol. 2024;49(9):1016-1023. doi:10.1093/ced/llae095 Sarah Romanelli¹, Gretchen D. Ball¹, Hassan Hamade¹, Melissa P. Zundell¹, Sangyoon Shin¹, Thami Senthilkumaran¹, Angela Lamb¹, Saakshi Khattri¹, Lourdes Perez-Chada², Joseph Merola³, Alice B. Gottlieb¹ 1. Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, United States. 2. Dermatology, Harvard Medical School, Boston, MA, United States. 3. Dermatology, The University of Texas Southwestern Medical Center, Dallas, TX, United States. Clinical Research: Epidemiology and Observational Research