Patient and Rheumatologist Perspectives of the Patient Self-Administered Inflammatory Arthritis Detection Tool: Implementation Considerations, Potential Barriers, and Opportunities.

Abstract

As part of a research program examining rheumatology referrals in British Columbia, the Patient Self-Administered Inflammatory Arthritis Detection (SAID) Study evaluated the SAID tool, which contains validated patient-completed questionnaires for identifying and prioritizing individuals with inflammatory arthritis, supporting its utility and feasibility. This article reports the perspectives of participating patients and rheumatologists regarding the SAID tool. A multimethods design was used to collect and analyze patient survey and rheumatologist interview data, with an emphasis on implementation considerations. Ninety-two patients who completed the questionnaires in the Patient SAID Study also provided feedback on their experience. Semistructured interviews were conducted with 3 rheumatologists. Quantitative and qualitative data were analyzed using Microsoft Excel and NVivo to identify usability, relevance, and barriers or enablers to implementing the tool in primary-to-specialist referral. Most patients found the SAID tool easy to log into (85%) and complete (82%). Across diagnostic groups, most (76%) believed it could help their general practitioner assess symptoms but emphasized the need for more nuanced response options and space for elaboration. Rheumatologists viewed the tool as brief, useful, and potentially valuable for triage, especially if integrated at the referral stage. Key barriers included time constraints, false negatives, and lack of integration with electronic medical records. All rheumatologists supported optional implementation led by motivated patients, provided it complemented-not complicated-existing workflows. With targeted modifications and appropriate implementation mechanisms, the SAID tool has the potential to improve the quality of referrals, support triage decision making, and address current gaps in access to rheumatology care within evolving digital health systems.