SpArking change for patients with psoriatic arthritis and axial spondyloarthritis in the UK: results from a UK Delphi consensus study

Objectives: To establish a UK-specific consensus on improving standards of care for patients with PsA and axial SpA through patient empowerment, education, access and optimal treatment approaches. Methods: A modified Delphi methodology was employed. A steering group of UK rheumatologists and pharmacists developed 56 consensus statements across four domains: patient empowerment, patient and healthcare professional (HCP) knowledge, access to healthcare and treatment principles. These statements were tested with a panel of 100 UK rheumatologists using a 4-point Likert scale. Consensus was predefined as ≥75% agreement. Results: Consensus was achieved for 98% (55/56) of statements; 93% (52/56) reached strong consensus (≥90%). Statements supported embedding patient empowerment tools (e.g. patient-reported outcome measures, patient activation measures), implementing patient-initiated follow-up and ensuring shared decision-making. Respondents strongly endorsed multidisciplinary care, tailored educational resources, psychological support and timely access to physiotherapy and biologics. Treatment decisions should prioritise clinical need and patient goals rather than cost alone. Conclusion: This UK Delphi consensus highlights expert agreement that best practice care for PsA and axial SpA should centre on patient empowerment, supported by multidisciplinary teams, education and equitable access to treatments. Implementing personalised, holistic care models has the potential to improve patient outcomes and reduce healthcare burden. Further research should validate these recommendations with patients and explore strategies for their integration into National Health Service practice.