What is the clinical and cost-effectiveness of a patient-initiated follow-up (PIFU) strategy compared to traditional care pathways in people with inflammatory arthritis treated with long-term immune-suppressing therapies? (TaILOR)

Research summary

Inflammatory arthritis usually prevents people from doing things through causing joints to become swollen and painful, or their spine to become stiff. People with arthritis usually require long-term treatment with medications and are typically reviewed in outpatient clinics every 6-12 months. Many of these appointments are unnecessary as patients are well at the time of follow-up, wasting patients’ time and NHS resources. NHS England has proposed that many people with inflammatory arthritis should no longer have routine follow-up appointments, but be seen if and when they have a problem related to their arthritis. This is called ‘Patient-Initiated Follow Up’ (PIFU) for which there are few studies to date. The TaILOR study aims to test whether PIFU is better than routine follow up. We aim to recruit 438 patients with stable inflammatory arthritis to have PIFU (patient-initiated appointments as required and an appointment in 2 years) or routine follow-up appointments (every 6-12 months) for 2 years whilst in the study. We will measure their quality of life and assess how well their disease is controlled, including the number of flares due to their arthritis, their use of medications, NHS health services and satisfaction with their care. A qualitative sub-study will also conduct detailed interviews with some patients and clinicians to understand their experience of PIFU. In a related but separate project, we will monitor quality of life and how NHS services are used by all patients switched to a PIFU pathway using information recorded routinely by hospitals and GPs across the UK. These individuals would not have been part of the TaILOR study. The results will be shared with participants, doctors, and patient and national organisations to guide the care of those with inflammatory arthritis. The results will also be presented at international research meetings and published in medical and scientific journals.

Principal Investigator

Prof Laura Coates

Contact us

Email: gail.lang@ndorms.ox.ac.uk

IRAS number

329838