statistically significant. In CARDERA (P¼0.009) and TITRATE (P¼0.002) a significantly greater proportion of patients achieved large reductions in pain scores in multivariable models with active treatment (ORs 1.9 and 2.2). Conclusion In our secondary analysis all forms of intensive management provided beneficial effects on pain in active RA and PsA. More patients achieved ‘‘low’’ endpoint pain scores with active treatment in all trials. In the two trials employing the most intensive management strategies (CARDERA/TITRATE) significantly greater reductions in pain scores and a greater proportion achieving substantial pain improvements with active treatment were seen. Our results support the use of intensive management to improve pain in patients with active RA/PsA. Disclosure I.C. Scott: None. D.L. Scott: None. F. Ibrahim: None. PRIMARY CARE Abstract citation ID: kead104.142 P101 UNDERSTANDING FIRST CONTACT PHYSIOTHERAPISTS EXPERIENCES OF REMOTE CONSULTATIONS IN PRIMARY CARE Nicola Walsh, Bethan E. Jones, Rachel Thomas and Zoe Anchors Centre for Health and Clinical Research, UWE Bristol, Bristol, United Kingdom Background/Aims First Contact Physiotherapists (FCPs) assess, diagnose and manage patients presenting with musculoskeletal disorders in primary care, without the need for prior GP consultation. Prior to COVID-19 almost every consultation was conducted in-person. Since the pandemic, many consultations are now undertaken remotely, a trend that is set to continue in line with the ‘Digital first’ strategy which seeks to enhance patient access to appointments. This aim of this study was to explore FCP views of remote consultations and how this impacted their role satisfaction and wellbeing. Methods This mixed methods two phase study consisted of an online survey investigating distributed via professional networks and through social media. The phase one survey explored consultation methods; levels of training; challenges and benefits; and a stress appraisal. Data were analysed descriptively. Respondents were invited to take part in phase two which included a semi-structured interview to gain an in-depth understanding of FCPs lived experience of remote consultation ways of working. Transcripts were thematically analysed. Results The online survey received n ¼ 109 responses from UK-based FCPs. Data revealed that despite the ‘Digital First’ push for continued remote consultations, the majority of FCPs (62%) used them for less than a quarter of their appointment slots. Whilst recognising that many patients found this format convenient, FCPs highlighted their own stress levels, citing poor efficacy, anxiety of misdiagnosis, feelings of isolation and increased administrative workload. Nearly two thirds (66%) of respondents had not received any training in how to conduct effective remote consultations. Follow-up interviews with n ¼ 16 FCPs highlighted coping strategies including following up with an in-person consultation and directing patients to other community health and wellbeing resources. In areas of high socioeconomic deprivation and poor health literacy additional problems associated with communica- tion difficulties, poor IT access and capability, and digital poverty were all cited. Conclusion Remote consultations may offer a convenient alternative for some patients. FCP responses suggest that the continued offer of remote consultation is decreasing now pandemic restrictions have been lifted, despite the push for continued digital working practices. The perceived lack of efficacy, and fear of missing important diagnostic information means that many FCPs are either returning to in-person consultation or following up with a second face-to-face assessment resulting in potential service inefficiencies. Additional challenges were identified in areas of high deprivation and low health literacy, and the value of this consultation format needs to be considered in this context. Future work should focus on the training and support needs of FCP staff who are engaging with remote working to ensure clinical effectiveness and staff wellbeing. Disclosure N. Walsh: Grants/research support; Walsh is funded by NIHR. B.E. Jones: None. R. Thomas: None. Z. Anchors: None. Abstract citation ID: kead104.143 P102 BARRIERS AND FACILITATORS TO LIFESTYLE CHANGE IN PEOPLE LIVING WITH GOUT: A SCOPING REVIEW OF QUALITATIVE STUDIES Lorraine Watson 1 , Nicola Cornwall 1 , Clare Jinks 1 , Katherine Bradbury 2 , Louise Goff 3 , Paul Little 4 , Christian D. Mallen 1,5 and Edward Roddy 1,5 1 School of Medicine School, Keele University, Keele, United Kingdom, 2 Dept of Psychology, University of Southampton, Southampton, United Kingdom, 3 Dept of Nutritional Sciences, King’s College London, London, United Kingdom, 4 Dept of Medicine, University of Southampton, Southampton, United Kingdom, 5 Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, United Kingdom Background/Aims Lifestyle, especially diet and alcohol, has been implicated in the causation of gout for centuries and the dietary factors which may trigger flares remain of great interest to people living with gout and their families. However, there is a lack of robust clinical trial evidence about the effectiveness of lifestyle change in people living with gout. The aim of this review was to establish the thoughts, feelings and experiences of people with gout, partners and healthcare profes- sionals about gout, to identify barriers and facilitators to behaviours relating to lifestyle change (diet, alcohol, and physical activity) in people living with gout. Methods A scoping review was undertaken following the stages recommended in Arksey & O’Malley’s scoping studies methodological framework. Databases Embase, MEDLINE, CINAHL, PsycINFO and AMED were searched from January 2000 to October 2021 to identify qualitative studies in gout. Themes were identified within the results of included qualitative studies using thematic synthesis (coding text in the results and then developing themes) and were discussed with both a stakeholder community of practice (COP) group and a patient and public involvement and engagement (PPIE) group. Results 1871 title/abstracts and 158 full papers were screened and 38 qualitative studies in gout were identified. Themes identified in the scoping review are presented in Table 1 and were corroborated with COP and PPIE group members. Examples of potential barriers to lifestyle change in people with gout include poor knowledge, confusing or inadequate information, uncertainty about effectiveness of diet in gout management, stigma, and a reluctance to see healthcare professionals. Potential facilitators for lifestyle change include the desire to prevent flares and pain, the provision of information, and that people with gout already search for information and avoid or consume certain foods. Conclusion This is the first scoping review to identify potential barriers and facilitators to behaviours relating to lifestyle change in people living with gout. Potential barriers include poor knowledge, problems with current information and stigma. The findings will be used to inform the development of the new lifestyle intervention for people living with gout in primary care. Disclosure L. Watson: Grants/research support; Lorraine Watson is funded by the National Institute for Health and Care Research (NIHR) School for Primary Care Research. [Post-doctoral Fellowship Grant reference 2020-347], this (abstract) presents independent research funded by the NIHR. The views expressed are those of the author(s) and not necessarily those of the (partner organisation), the NHS, the NIHR or the Department of Health and Social Care. N. Cornwall: None. C. Jinks: Grants/research support; Clare Jinks is part funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands. K. Bradbury: Grants/research support; Katherine Bradbury is funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Wessex. L. Goff: None. P. Little: None. C.D. Mallen: Grants/research support; Christian Mallen is funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands and the NIHR School for Primary Care Research, The School of Medicine as received funding from BMS for a non-pharmacological AF screening trial, Christian Mallen has received grant funding from Wellcome and the Medical Research Council. E. Roddy: None. ii70 POSTERS Downloaded from https://academic.oup.com/rheumatology/article/62/Supplement_2/kead104.142/7136390 by guest on 26 April 2023