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each discussing techniques and score discrepancies; standard continuation sheets in RA patient case notes were replaced by a one page proforma including the DAS-28 mannequin. The hand position was adapted so that the palms faced backward rather than forward to make the mannequin more user-friendly. Results: The original audit comprised 40 patients. Only 1 had a target set. New RA diagnosis (n1⁄41): baseline performed. Recent onset RA (n1⁄4 7): 4 scored in clinic, no monthly repeats until control. Established RA (n1⁄432): 9 scored in clinic (5 had never been scored and 10 not scored in the last year). DAS-28 was performed in 4/6 biologic patients. In the re-audit there were 54 patients (due to extra staff). Targets were set in all. New RA diagnosis (n1⁄42): baselines performed. Recent onset RA (n1⁄45): 3 scored in clinic, 2 had monthly repeat until control. Established RA (n1⁄4 47): 33 scored in clinic (3 had never been scored and remainder scored in the last year). DAS-28 was performed in 8/8 biologic patients. Overall DAS-28 performance was 35% in the original and 70% in the re-audit (Table 1). Conclusion: Described are three simple low-cost initiatives that doubled overall performance of DAS-28. Performing monthly scores until disease control in newly diagnosed patients remains a challenge due to clinic capacity. Involvement of the wider MDT or primary care may offer a potential solution.

rheumatology

105. Adherence to Disease-Modifying Anti-Rheumatic Drugs in Patients with Inflammatory Arthritis: A Survey of Patients Attending the Rheumatology Outpatients Department