BASHH National Audit Group

Clinic Policy Audit on the Management of Sexually Acquired Reactive Arthritis

BASHH Clinical Effectiveness Group Auditable Outcome Measures (2008):

  • A sexual history should be taken, particularly covering the last three months (target 100%)
  • A full screen for STIs, including an HIV test, should be offered (target 100%)
  • Patients should have an ESR, CRP or PLV measured (target 100%)
  • Patients should have a FBC performed (target 100%)
  • Urinalysis should be performed in all cases (target 100%)
  • Appropriate antibiotic therapy for any genital infection identified should be prescribed as detailed in the relevant guidelines (target 100%)
  • Partner notification rate, according to gonorrhoea and C.trachomatis guidelines, where an STI is identified
  • Prevention of recurrent genital infection
  • Patients prescribed an NSAID should have a documented prior assessment of risk for gastrointestinal complications (target 100%)
  • Patients prescribed an NSAID should have a documented prior assessment of cardiovascular risk (target 100%)
  • Duration of inability to work (target 80% 6 months or less)
  • Need for admission to hospital (target less than 10%)
  • Duration to full recovery (target 80% 6 months or less)
  • Presence of erosive joint damage (target 20% or less)
  • Presence of longterm disability (target 20% or less)
  • Patients with significant extragenital involvement should be referred to the appropriate specialist (target 100%)
  • Patients should receive a detailed verbal explanation of their condition (target 100%)

Four essential questions are: Qs 4, 5, 6, 9 highlighted in yellow

Q.1a: Type of clinic. Please tick all that apply:

District general hospital

Teaching hospital

Community-based service

Other Please specify:

Q.1b: Name of organisation:

Q.2a: Annual male clinic attendances (new and re-book episodes):

Q.2b: Annual female clinic attendances (new and re-book episodes):

Q.2c: Total number of male patients seen with sexually acquired reactive arthritis (SARA) in your clinic during <please state audit interval>:

Q.2d: Total number of female patients seen with sexually acquired reactive arthritis (SARA) in your clinic during<please state audit interval>:

Q.3: Please indicate which of the following symptoms patients thought to have SARA are routinely asked about in your clinic. Please tisk all that apply:

 Constitutional symptoms (fever, fatigue, anorexia)

Eye symptoms

Skin symptoms

Joint symptoms

 Bowel symptoms

 Other symptoms, please specify:

Q.4: Please indicate which of the following tests are routinely offered in your clinic to patients thought to have SARA.Please tisk all that apply:

 Urethral microscopy (men)

 Cervical microscopy (women)

 Testing for genital chlamydial infection

 Testing for genital gonorrhoea infection

Testing for HIV infection

Testing for syphilis

 Temperature

Erythrocyte sedimentation rate

C-reactive protein

Plasma viscosity

Full blood count

Urinalysis

HLA B27

 X-rays of affected joints

 X-ray of the sacro-iliac joints

Other tests, please specify:

Q.5: Are patients thought to have SARA routinely offered referral to any of the following services?Please tisk all that apply:

All patients Selected patients No patients

Rheumatology

Dermatology

Ophthalmology

Physiotherapy

Other, please specify:

Q.6: Are any of the following routinely prescribed or recommended to patients diagnosed with SARA?Please tisk all that apply:

Rest Yes No

Non-steriodal antiflammatory drug (NSAID) Yes No

Antibiotic treatment Yes No

Other, please specify: Yes No

Q.7a: Please state the first-line NSAID treatment routinely prescribed by your clinic for SARA (name/dose/method of administration/duration):

Q.7b: Please statethe first-line antibiotic treatment routinely prescribed by your clinic for SARA (name/dose/method of administration/duration):

Q.8a: Is it your clinic policy to document that a discussion with the patient about SARA was provided?

 Yes No Not documented

Q.8b: Are patients treated for SARA routinely offered written information on SARA in your clinic?

 Yes No

Q.9a: Is it your clinic policy routinely to offer follow up to patients with SARA at your clinic?Please tick all that apply:

 Follow up is offered

 No follow up offered

 Follow up left to patient choice

 Other, please specify:

Q.9b: If Yes, which of the following are routinely documented during follow up?Please tick all that apply:

Presence or absence of recurrence of genital infection

Presence or absenceof erosive joint damage attributable to SARA

Presence or absenceof inability to work or function as a student

Presence or absenceof long term disability

Presence or absenceof full recovery

 Other, please specify:

Q.10a: Does your clinic have a written policy, protocol, treatment guideline, care pathway or other document dealing with the management of SARA?

Yes No 

Q.10b: If Yes, is this based on the BASHH Guideline for the management of SARA?

Yes No 

Q.11: Please provide any additional comments about the management of SARA in your clinic:

Thank you for completing this questionnaire

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