P164 Enhancing safe access to care: are virtual biologics services in dermatology needed?

Abstract Biologics and Janus kinase (JAK) inhibitors have revolutionized treatment options for patients with dermatoses. Current demand is rapidly exceeding our capacity to accommodate face-to-face (F2F) appointments due to time constraints and limited resources. Many of our patients requested virtual over F2F consultations. In our dermatology department, we run a fortnightly clinic for biologics and JAK inhibitors involving a part-time consultant dermatologist, an associate specialist and a clinical nurse specialist. Currently, we have 259 patients receiving biologics and JAK inhibitors, with numbers continuing to increase. Our aim was to evaluate the efficacy and patients’ preferences of virtual vs. F2F assessments in monitoring and reviewing dermatology patients on biologics and JAK inhibitors. We conducted a 6-week prospective pilot study of patients to evaluate the efficacy, safety and patients’ preferences. A five-point Likert questionnaire was used to identify current patient satisfaction levels, patient preferences for type of clinic (virtual or F2F) and barriers to accessing F2F clinics. The questionnaire also allowed open comments for improvements or concerns, enabling qualitative data collection in addition to the quantitative data. The average distance travelled by patients to attend clinic was 4.58 miles. Ten of 50 patients travelled > 40 miles, emphasizing the travel burden and need for virtual consultations. In total, 47 of 50 prospective patients for biologics undertook the survey. There were 25 male patients and 22 female. The mean patient age was 53.5 years (range 32–87). Thirty-one patients (66%) had psoriasis, 5 of 31 (16%) had concomitant psoriatic arthritis, 12 (26%) had atopic dermatitis, 3 (6%) had hidradenitis suppurativa and 1 patient (2%) had Schnitzler syndrome. Overall, 45 of 47 patients surveyed were follow-up patients. Twenty-five patients undertook an F2F appointment (including two new patients) and 22 patients had a virtual (telephone) appointment. Twenty-nine patients (62%) preferred a virtual appointment, whereas 14 (31%) wished to be seen F2F; 4 (9%) patients were indifferent. In total, 45 of 47 (96%) were completely satisfied with their modality of consultation. Regarding outcome measures, 43 of 45 (96%) follow-up patients had a Dermatology Life Quality Index < 7, 29 of 31 patients with psoriasis had Psoriasis Area and Severity Index < 10, and none of 12 patients with atopic dermatitis had Eczema Area and Severity Index < 10. In conclusion, this pilot study shows evidence to increase virtual consultations for stable patients established on treatment with biologics, allowing new patients to access biologic treatment in a timely fashion.