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Background Aotearoa New Zealand (AoNZ) has no agreed models for rheumatology service provision in government-funded health care. We aimed to describe what people with inflammatory rheumatic diseases who have used rheumatology services view as being important in those services, and map these views to previously collated statements describing best practice components of rheumatology services from international recommendations. If these statements did not capture all service aspects that people with inflammatory rheumatic diseases considered important, we aimed to co-create new statements with our patient-participants. Methods We conducted one focus group and an interview with people with inflammatory rheumatic disease who had used a government-funded rheumatology service in the previous 5 years (patient-participants) and analysed data using thematic analysis. The research team mapped subthemes to previously collated best practice recommendations that had been included in a Delphi consensus exercise with rheumatologists in AoNZ and proposed new statements, based on patient-participant data. Patient-participant feedback on thematic analysis and the new statements led to a refining of statements. A patient-partner in the research team informed research design and data analysis. Results Patient-participants viewed it as highly valuable for rheumatology services to respect and value their experiences as people and patients, and those of their whānau (Māori word for family). They expected rheumatology services to provide the right care, at the right time. Many of the subthemes mapped to the best-practice statements. However, three new principles and three new statements were developed and refined by patient-participants. The three principles addressed valuing individuals, and their whānau (family) and their experiences, and providing a patient-focused health system that supports patient participation in decision-making and self-management, and patient education. New statements related to having a specific rheumatologist and other staff for comprehensive care, having adequate nurse staffing, and active provision of outside services and support. Conclusion It was important to patients that rheumatology services demonstrated that patients and their whānau (family) were valued. The inclusion of people with rheumatic diseases who are users of rheumatology services in service development can provide valuable insights to inform how services should be delivered.

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BackgroundDue to geographic isolation and border controls, Aotearoa New Zealand attained high levels of population coronavirus disease-19 (COVID-19) vaccination before widespread community transmission of Omicron variant COVID-19 in early 2022. This provides a unique opportunity to examine outcomes in people with rheumatic diseases immunologically naive to COVID-19.ObjectivesThis study aims to describe the outcomes of Omicron variant COVID-19 infection in people with rheumatic diseases in Aotearoa New Zealand.MethodsWe conducted an observational study of people with inflammatory rheumatic disease and COVID-19 infection from centers in Aotearoa New Zealand between 1 February to 30 April 2022. Data were collected via the Global Rheumatology Alliance Registry, including demographic and rheumatic disease characteristics and COVID-19 vaccination and outcomes. Multivariable logistic regression was used to explore associations of demographic and clinical factors with COVID-19 hospitalisation and death.ResultsA total of 1599 cases were included, with 98% from three hospitals that systematically identified all patients from rheumatology clinics who had COVID-19 infection. At the time of COVID-19 infection, 1513 cases (94.6%) had received at least two COVID-19 vaccinations. Hospitalisation occurred for 104 (6.5%) cases, and 10 (0.6%) patients died. A lower frequency of hospitalisation was seen in cases who had received at least two vaccinations (5.9%), compared to cases who were unvaccinated (20.6%) or who received a single vaccine dose (10.7%). In multivariable adjusted models, people with gout (OR 2.2 95% CI 1.02, 4.77) or connective tissue diseases (CTD) (OR 2.78 CI 1.61, 4.80) had increased risk of the combined outcome of hospitalisation and death, compared to people with inflammatory arthritis. Glucocorticoid and rituximab use were associated with 3 to 6 times higher odds of hospitalization and/or death. All cases who died had three or more co-morbidities associated with a known higher risk of poor outcomes or were over 60 years old.ConclusionIn this cohort of people with inflammatory rheumatic diseases with high vaccination rates, severe outcomes from Omicron variant COVID-19 were infrequent. The hospitalisation rate during COVID-19 infection was higher in people who had not completed the primary vaccination course, had gout or CTD, and used glucocorticoids. These findings suggest that outcomes of Omicron variant COVID-19 infection among people with rheumatic disease who are vaccinated but immunologically naive to prior COVID-19 variant infections were favorable.AcknowledgementsThere was no specific funding for data collection. Data analysis was funded by the COVID-19 Global Rheumatology Alliance. The Global Rheumatology Alliance registries are supported by the American College of Rheumatology and European Alliance of Associations of Rheumatology but the views expressed here are of the authors.We thank our colleagues who entered patients to the cohort who include Ms J Heslett, Dr S Bourke, Dr E Chan, Dr S Jordan, Dr K Lindsay, Dr R Murdoch and Dr S Stebbings,Disclosure of InterestsJonathon Brooks: None declared, Anna Montgomery: None declared, Nicola Dalbeth Consultant of: Personal fees from AstraZeneca, Dyve Biosciences, Horizon, Selecta, Arthrosi, JW Pharmaceutical Corporation, PK Med, LG Chem, JPI, PTC Therapeutics, Protalix, Unlocked Labs, Hikma, all outside this abstract, Mark Sapsford: None declared, Amy Cooper: None declared, Rachel Ngan Kee: None declared, Vicki Quincey: None declared, Jean Liew Grant/research support from: Pfizer, outside this abstract, Suleman Bhana Shareholder of: Owns restricted stock units with Pfizer as a Pfizer employee, Consultant of: Honoraria from AbbVie, Horizon, Novartis, Pfizer, has received travel support from Pfizer, Employee of: Pfizer Inc, Monique Gore-Massy Consultant of: Patient consultant for Aurinia Pharmaceuticals, Boehringer Ingelheim, Johnson & Johnson, Bristol-Myers Squibb, all unrelated to this abstract. Receives honoraria from Aurinia Pharmaceuticals, Boehringer Ingelheim, Bristol-Myers Squibb, all unrelated to this abstract, Jonathan Hausmann Consultant of: Consulting fees from Novartis, Pfizer, Sobi and Biogen, all unrelated to this manuscript, Pedro Machado Speakers bureau: PMM has received consulting/speaker’s fees from Abbvie, BMS, Celgene, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript, Paul Sufka: None declared, Emily Sirotich: None declared, Philip Robinson Speakers bureau: PR reports personal fees from Abbvie, Atom Biosciences, Eli Lilly, Gilead, GlaxoSmithKline, Janssen, Kukdong, Novartis, UCB, Roche, Pfizer;, Grant/research support from: Meeting attendance support from BMS, Pfizer and UCB and grant funding from Janssen, Novartis, Pfizer and UCB Pharma., Zachary Wallace Consultant of: Consulting fees from Zenas Biopharma, Horizon, Sanofi, Shionogi, Viela Bio, and MedPace, all outside this abstract., Grant/research support from: Research support from Bristol-Myers Squibb and Principia/Sanofi, all outside this abstract., Jinoos Yazdany Consultant of: Consulting fees from Astra Zeneca, Aurinia, Pfizer, all unrelated to this manuscript, Grant/research support from: Grants from Gilead, Astra Zeneca, BMS Foundation, all unrelated to this manuscript, Rebecca Grainger Speakers bureau: RG reports personal fees from AbbVie, Janssen, Cornerstones, Novartis; meeting attendance support from Pfizer.