Background Receiving a diagnosis of chronic rheumatic disease has a profound impact not only on patients, but also on their spouse (life partner). These might be affected because of fear and uncertainty of a life-long illness or by potential changes in role, quality of life, and financial threats in treatment costs and lost earnings. These changes can have a profound effect on quality of life for both parties and the long term prognostic of the rheumatic patient might be influenced. Objectives To identify the potential differences between the support offered by the life partner in the case of chronic rheumatic and shor acute diseases. Methods A structured questionnaire was developped and applied to 51 chronic rheumatic - long term -patients (LTP) and 37 patients suffering from short term (acute) illness (STP). The activities have been done during 2013 involving both outpatients and inpatients. SPSS 19 was the software used in this case. Results No major difference has been found between LTP and STP groups regarding age, sex ratio, level of education, access to health services and marital status. However LTPs receive less support from their life partners (p<0.05) in areas of: understandig of emotional problems, sharring the same emotional concerns, keeping the quality of intimate live, identification of new scientific information that might improve the managment of disease. On the other side the partners of LTPs are much more aware of the finaincial impact of their partner's disease. Conclusions Our study identified a pattern addopted by the life partiners in case of chronic rheumatic diseases (LTP) that is significantly diffrent for the one of life partners of short acute diseases patients (STP). This could be the first step in the development of a communication campaign amimed to raise the quality of support the life partners are ready to offer to chronic rheumatic patients with final results in the quality of life and long term prognosis. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.2167

Background Chronic rheumatic patients have to face various needs of communication throughout their illness. Their doctors, nurses and fellows suffering from similar diseases are the main oral sources of information. Based on their availability, perceived competence, presumed quality or easiness to access these sources are used to address the information needs. In order to improve their education of is important to know the way our rheumatic patients use these sources to fulfill their information needs. Objectives To identify the patients' preference for a certain source of information in relation with their particular needs. Methods A structured questionnaire developed to assess the preference for one of the four main source of information (senior & junior rheumatologists, nurse specialists and similar patients) in relation with 12 problems connected in 5 areas: diagnostic & treatment, alternative management, impact of disease, dealing with administrative obstacles and source of additional information. For each item we determined the level of preference as a mean of answers (on a 0 to 10 scale) we received. 205 rheumatic patients from five tertiary centers accepted to answer the questionnaire. SPSS 19.0 have been used for statistical analysis and a p<0.05 was considered significant. Results The highest levels of preference (mean (SD)) for information given by specialized nurses have been computed for: additional source of information (7.3 (2.7)), future evolution of disease (7.2 (2.9)), impact of disease on personal life (7.1 (2.8)), seriousness of disease (6.9 (2.7)), adverse reactions to treatment (6.8 (2.7)). However in none of 12 problems the nurse was not the most preferred source of information and in just one case she was the 2nd best choice. Patients with lower levels of formal education and those from urban areas scored higher for nurses but did not changed the hierarchy. Nor the disease duration or the gender of responder have influenced the final results. Conclusions The study reveals a potential need for strengthening the role of specialized nurse as a quality source of information for chronic rheumatic patients in the context of her increasing role in long-term management. However, the areas we identified in this study as being higher rated for nurses might benefit from their input even sooner. Specialized nurses should develop their own action plan to solve this issue in the benefit of our patients. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.2689

Background Chronic rheumatic patients come in contact with health system more often than regular people that give them the opportunity to better identify both the strengths and weakness of this system. Rheumatic patients that receive biological therapy (BIOTh) are a special group of chronic patients usually having more severe diseases and a potential for additional complications throughout their disease. Independent of these, rheumatic patients receiving biologics are frequent subjects of observational studies including various types of medical registers. Sometime they are compared with rheumatic patients that do not receive biological treatment (nBIOTh) but do these two different kind of patients receive same attention from the medical system? If the answer is different from yes then we might experience a bias in these studies. Objectives To evaluate a possible difference between BIOTh and nBIOTh in terms of medical attention these groups receive. Methods We used a standardized patient satisfaction survey to perform an indirect measurement of the medical attention received by every patient. The surveys covers eight distinct areas split in 23 items: patient's needs, existence of coordinated medical help, easiness of access to medical care, support for information, physical comfort, emotional support, support for proper family relationship, global perception. The survey was conducted in three academic hospitals. Data analysis was done by using SPSS 19 software. Results A number of 84 patients have been included in BIOTh group and 44 in nBIOTh group. No significant difference in terms of underling disease, education, sex and access to medical services was found between groups. Mean age was a little bit higher in nBIOTh than in BIOTh: 52,2 (13,5) vs 50,2 (13,2) years but we considered this difference not significant for the purpose of this study. We found a systematic difference between groups that favor BIOTh as following: in 7 of the 23 items evaluated, the patient satisfaction was significant higher in case of subjects under biological therapy, in the remaining 18 items no statistical difference occurred; no item favored patients without biological therapy. The difference was even higher when BIOTh group was restricted to those subjects with more than two years of biological therapy. Conclusions Our results suggest that chronic rheumatic patients on biological therapy seems to receive more attention than rheumatic patients that do not receive such therapy. This conclusion is particularly important for those observational studies that compare data from patients exposed and not exposed to biological therapy. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.2282

BackgroundThe professional's monopoly on knowledge about disease and its treatment is something gone now, in the era of internet and patient consumerism. In addition, the interest of rheumatologists (and the interest of the society, too) shifted toward early recognition of the disease and early arthritis clinics. Education is definitely one of the solutions to increase the awareness of potential patients regarding rheumatic diseases. However most of rheumatic diseases are not very frequent in the population that raise the problem of cost efficacy of the education process. Per Eliot Freidson's view, the members of every community of whatever kind share some cultural understandings about disease, treatment, and cure. The lay community network could be considered an instrument for dissemination of proper knowledge regarding health and could help to earlier recognition of a sign of disease related to early arthritis.ObjectivesTo identify the opportunity of using lay network for early arthritis referral. In addition, we intended to identify the most suitable vectors from this network to be used for education and dissemination of medical knowledge.Methods48 rheumatic patients (mean age (SD): 50.8 (14,7)) consecutively admitted in one tertiary clinic have been invited to answer to a structured questionnaire. Sex ratio (M: F) was 1:2, average disease duration 7.7 (8.3) years.ResultsIn 28.3% cases the first sign of disease was noticed not by the patient but by somebody else, for 36.7% a delay of several months to one year was declared between first sign of disease and professional examination, 71.7% use to discuss bout health problems with their lay network (often and very often), 76.1% consider them able to give pertinent advices regarding the disease they suffer from, 45,7% are ready to act as an education vector and 41,3% are ready to participate in additional education programs. They interest in such activity is not related to gender, education level or work status.ConclusionsLay network referral could be a powerful instrument to reduce the duration between onset of rheumatic symptoms and medical visit, to increase the awareness regarding rheumatic disease, to reduce the cost of health education. Health professionals should understand how to use these networks.References Freidson, Eliot. 1960. “Client Control and Medical Practice.” American Journal of Sociology 65:374–82.Barley, Stephen R., and Gideon Kunda. 2004. Gurus, Hired Guns, and Warm Bodies: Itinerant Experts in a Knowledge Economy. Princeton, NJ: Princeton University Press. Disclosure of InterestNone declared