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Background/Aims Since the outbreak of COVID-19, clinicians adapted by switching from face-to-face to remote consultations in order to limit transmission and continue delivering high-quality outpatient services. We aimed to investigate patient- and clinician-related factors which may affect outcomes in follow-up telephone consultations. Methods Patients who attended follow-up clinic appointments via telephone consultations in the month of March 2022 were retrospectively evaluated. Data collected were demographics, main active diagnosis, current treatment and the clinicians’ grade. Factors associated with categorical outcomes i.e. decision to request a subsequent face-to-face appointment, investigations, referrals to other specialties, and to discharge a patient, were assessed using univariate logistic regression analysis. Univariate linear regression analysis was performed to identify factors associated with the length of follow-up intervals. Results 314 patients were included; 218 (69%) female, median (IQR) age 63 (53-72) years. The most common diagnosis was rheumatoid arthritis (39%). 66% of patients were on DMARDs and 16% were on steroids. There were 48 (15.3%) requests for a subsequent face-to-face appointment and 28 (8.9%) discharges. There were more investigations (20.4%) requested compared to referrals (4.5%). Specialist nurses (SpNs) were the single largest group who conducted the telephone consultations (46%). SpNs were more likely to request face-to-face appointments [odds ratio (OR) 2.16 95% CI (1.16, 4.12) P=0.017] and investigations [OR 1.77 (1.02, 3.11) P=0.043] compared to other clinicians. In contrast, consultants were less likely to request investigations [OR 0.34 (0.16, 0.66) P=0.002]. Other factors associated with a subsequent face-to-face appointment were steroid [OR 3.00 (1.45, 6.02) P=0.002] and conventional DMARD therapy [OR 2.90 (1.50, 5.92) P=0.002]. In terms of discharges, consultants were more likely to discharge a patient [OR 4.05 (1.83, 9.46) P<0.001]. Patients with a diagnosis of inflammatory arthritis [OR 0.01 (0.00, 0.06) P<0.001] and on conventional DMARDs [OR 0.03 (0.00, 0.14) P<0.001] have a lower probability of being discharged. In terms of specialty referrals, there were no significant factors identified. An analysis of 197 clinic letters which specified follow-up intervals found that consultants were more likely to request longer follow-up intervals [beta coefficient 0.32 (0.13, 0.50) P<0.001] whereas SpNs were more likely to request shorter follow-up intervals [beta coefficient -0.52 (-0.65, -0.39), P<0.001]. Conclusion These findings suggest that clinicians’ experiences and roles may influence the decisions made following a telephone clinic consultation. For example, SpNs are usually involved in drug monitoring and therefore, have a higher likelihood to request face-to-face reviews, shorter follow-up intervals and investigations. The consultant’s level of experience may explain the higher probability of discharging patients and the lower probability of requesting investigations. Further studies over a longer duration are needed to determine other factors which may affect the clinical decisions made from telephone clinic consultations. Disclosure A. Ramli: None. X. Ong: None. S. Chitale: None. E. Gladston Chelliah: None.

Background/Aims It is vital to evaluate the implementation of telephone clinic (TEL) consultations since the COVID-19 pandemic began. We investigated the rates of conversion to face-to-face reviews (F2F) and discharges following a TEL consultation in our department, including the factors influencing these outcomes in 2 different years. Methods Patients who attended TEL consultations in April 2021 and March 2022 were retrospectively reviewed. Factors associated with conversion to F2F and discharges were identified using multivariate logistic regression analyses, adjusting for age and sex. Results 578 patients included [314 (2022) vs 264 (2021)]; 69% female (both years) with similar median ages [63 (2022) vs 65 years (2021)]. The most common diagnosis was rheumatoid arthritis [39% (2022) vs 54% (2021)]. The rate of conversion to F2F was lower in 2022 (15.3% vs 29.9%). In 2021, multivariate analyses found that a consultant’s review was associated with a conversion to F2F [adjusted odds ratio (aOR) 2.22 95% CI (1.26, 3.90) P-value=0.005] whereas an SPN’s (specialist nurse) review was associated with a reduced likelihood [aOR 0.48 (0.28, 0.82) P-value=0.008]. In contrast, an SPN’s review in 2022 was associated with a conversion to F2F [aOR 2.02 (1.07, 3.90) P-value=0.032]. Other factors associated with F2F appointments in 2022 were current steroids [aOR 3.44 (1.63, 7.14) P-value<0.001] and conventional DMARD therapy [aOR 3.14 (1.60, 6.55) P-value=0.001]. The rate of TEL discharges was higher in 2022 (8.9% vs 5.7%). In 2022, a consultant’s review was associated with discharges [aOR 4.07 (1.83, 9.53) P-value<0.001] whereas an SPN’s review has a lower likelihood of discharges [aOR 0.04 (0.00, 0.17) P-value=0.001]. These associations were not identified in 2021. In both years, patients with inflammatory arthritis and on conventional DMARDs have a reduced likelihood of being discharged. Conclusion The lower rate of conversion to F2F and increased rate of discharges in 2022 suggest a higher level of confidence among clinicians in undertaking telephone consultations as they become more experienced. Patient factors such as diagnoses and current treatment influenced the decision regarding F2F appointments and/or discharges, as expected. In 2021, SPNs might have a higher threshold to request a F2F appointment as clinical services have been recovering since the pandemic began. As TEL reviews became more commonplace in 2022, their threshold may have been subsequently lowered. The increased likelihood of conversion to F2F following a consultant’s review in 2021 suggests a higher incidence of flare-ups as remote consultations were increasing. In terms of discharges in 2022, the differences between consultants and SPNs may reflect the clinicians’ level of experience in making these decisions. As telephone reviews become more regular, it is important to appreciate the evolving challenges that rheumatology clinicians may face in the post-pandemic years and any issues are identified and addressed accordingly. Disclosure A. Ramli: None. X. Ong: None. S. Chitale: None. E. Gladston Chelliah: None.