Digitising the seven-day urticaria assessment (UAS7) to support care closer to home
At a glance
Patients with chronic spontaneous urticaria who are being assessed for treatment may need to complete a UAS7 disease-activity questionnaire over a seven-day period. Traditionally, this can involve paper questionnaires sent and returned through the post or additional contact with hospital teams.
Working with an NHS NHS Ayrshire and Arran in Scotland, Sciensus developed a digital assessment pathway that allows patients to complete the required questionnaire remotely through a daily SMS link.
The first patient assessment cycles have now been completed, with strong early adherence across the seven-day assessment period. The pilot is exploring whether a simpler digital process can reduce administrative burden, support patients to complete the assessment reliably and provide one of the building blocks for a broader urticaria homecare pathway.
The challenge
The UAS7 is an established part of determining eligibility for treatment, but its administration can create additional work for patients and clinical teams.
In some NHS services, questionnaires are sent to patients on paper and returned once the seven-day period has been completed. That creates several opportunities for the process to break down. Forms may be incomplete or lost, patients may miss individual days and NHS teams may need to follow up to obtain the information they require.
Some services may use clinic contact to support the assessment, which can provide greater oversight but also uses outpatient capacity for an activity patients may be able to complete remotely.These practical issues become particularly relevant when considering how more elements of urticaria care could be delivered outside hospital. A reliable way to collect the information clinicians need is an important part of making that pathway work.
The approach
Sciensus worked with multiple NHS teams to develop a digital alternative to the existing paper-based process. During the pilot, patients receive an SMS link each day throughout the seven-day assessment period. They complete the UAS7 remotely, allowing their responses to be captured electronically and brought together for review. The information can then be returned to the hospital in a format that fits its existing clinical workflow. The digital pathway keeps the clinical assessment itself unchanged. The change is in how patients complete and submit the information, with the aim of making the process easier to manage remotely.
SMS was chosen as a simple way to reach patients without requiring them to download another application before taking part thus reducing technology as barrier to inclusion of most patients. The initial model can also evolve over time, with the potential for similar monitoring functionality to be incorporated within the Sciensus patient app.
The first implementation is being tested with the NHS Ayrshire and Arran, providing an opportunity to understand how the pathway works for both patients and clinical teams before considering wider adoption.
The results (so far)
The pilot is at an early stage, but the first UAS7 cycles have now been completed. Early experience has shown approximately 80% adherence to the daily digital questionnaires, providing an encouraging initial indication that patients can complete the assessment reliably outside the clinic.
The approach also removes the need to distribute and reconcile paper questionnaires for participating patients and gives clinical teams access to structured information collected throughout the assessment period.
As the pilot develops, the evaluation will look at a larger number of patients and measure completion rates in more detail. The team also plans to explore the impact on administrative workload and whether the approach can reduce clinic activity associated with managing the assessment process.
Why it matters
Moving appropriate care closer to home depends on the whole pathway being workable for patients and NHS teams. Administrative processes may appear relatively small in isolation, but they can create additional workload and make hospital-based care easier to manage than a home-based alternative.
Digitising the urticaria assessment removes one of those practical barriers. Patients can provide the required information from home, while NHS teams receive a structured record without relying on paper moving between the patient and hospital.
The pilot also provides an opportunity to learn how digital monitoring can support a broader urticaria homecare pathway. If the approach continues to demonstrate reliable completion and reduced administrative burden, it could potentially be adapted for other NHS organisations managing the same or similar patient populations.
Conclusion
The urticaria pilot is testing a relatively simple change to an established clinical process: allowing patients to complete their seven-day assessment digitally from home.
Early adherence has been encouraging, and the next stage will build the evidence around patient completion, NHS workload and the wider impact on the pathway.
The learning will help Sciensus and NHS teams understand how digital assessment can support more flexible models of care while maintaining the information clinicians need to make treatment decisions. Importantly, demonstrating that the model works in practice also creates the opportunity to apply the same approach more widely. The principles being tested here, remote patient reporting, structured digital monitoring and integration into existing clinical workflows, could potentially be transferred to other therapy areas where regular assessment or monitoring is needed to support treatment decisions and care closer to home.
