What is the study about?

Axial spondyloarthritis (axSpA) is an inflammatory condition affecting 270,000 people in the UK, causing pain, stiffness and damage to the spine, pelvis and joint. Symptoms, including back pain, start in early adulthood and progress with time. Currently it takes 5-8 years to get a diagnosis. Back pain is a common symptom and the minority have axSpA, so it is difficult for GPs to tell if back pain is due to inflammation. Effective treatments are available but delayed diagnosis leads to less benefit and worse health problems.

The study aims to help General Practice Clinicians (GPCs) identify patients with inflammatory back pain faster to enable early diagnosis and timely access to treatment. We will design a new tool, to be integrated into GP computer systems, to help the GPCs decide if a patient needs to be referred to a specialist, and the impact of this on the patients’ wellbeing and delays in diagnosis.

Who can take part in the study?

Individuals aged 16-50 years, with chronic back pain which started before age 45.

People taking part in the study must be willing to undergo X-ray, MRI, and blood tests.

What is being tested in the study?

Participants will attend a research clinic, where they’ll complete questionnaires, have clinical examinations, blood tests, x-rays and Magnetic Resonance Imaging (MRI) scans. We will determine which signs, symptoms and tests pick out those most likely to have axSpA, as diagnosed by a specialist. We will then use between 3 to 5 of these factors to create a new referral tool.

What are we trying to find out?

The aim is to develop a new tool (pop-up window on GP computer screen) to help General Practitioners refer patients with axial spondyloarthritis (axSpA) into rheumatology clinics at the hospital. The tool will be tested in a future randomised controlled trial.

How many patients do we need?

Up to 900

Funder

National Institute for Health and Care Research (NIHR)