April 2019 network news

On average, the helpline at Versus Arthritis deals with 1,700 enquiries a month.

The most common calls are about osteoarthritis, rheumatoid arthritis and fibromyalgia, with pain and medication the most common requests for information.

Helpline Advisor, Jane, lets us in on a typical day on our helpline.

Jane Longden, Helpline Advisor for Versus Arthritis - “I have worked as a Helpline Advisor for Versus Arthritis since 2017. I was drawn to the empathy and patience demanded of this role due to my background in counselling and customer services. My aunt passed away in 2017 due to symptoms associated with rheumatoid arthritis which prompted me to look further into the condition and how to support others in need.

Everyday is different and I am always learning. Callers will ring to talk about a range of topics, from medication and benefits, to general advice for managing their pain or talking to family and friends about their condition. Sometimes, callers are upset and unsure as to why they’ve rung and may be suffering from other illnesses, including poor mental health. In cases such as these, the most important thing to do is lend a listening and sympathetic ear, and simply be there. Handling calls when the person at the end of the phone is upset, especially when unable to give them the clear-cut answers they need, can be one of the most challenging aspects of the role.

The job is hugely rewarding, especially knowing that I am helping callers along their personal journeys with arthritis, empowering them to better understand their conditions, and comforting them with the knowledge that they are not alone.

Crucially, I learn from my callers too – the lives and experiences of those with the condition help to shape our knowledge and how we respond to each new phone call. This in turn helps to make Versus Arthritis’ services better. Every new piece of information we find has the power to help thousands more people.

We would like to share our new promotional material* with you. This can be given directly to your patients or placed in waiting areas at your place of work and help signpost people to our services. You can order by calling 0800 515 209.

(*max 100)

Artificial Intelligence (AI) is already being used in most sectors, and with the NHS recently publishing its code of conduct for AI techniques, AI is moving even further into healthcare. Versus Arthritis has been using AI in its virtual assistant, which answers questions about arthritis through our website, since 2016. Working alongside IBM, we’re now looking at how it could be developed to provide more support for people with arthritis.

Integrating with the helpline

One of the benefits of the virtual assistant is that it is a ‘faceless’ interaction, so people may feel more comfortable asking it personal questions. However, where people tell the virtual assistant that their condition is affecting their mental health, for example, support may be better provided by someone who can listen and understand the complexities of the situation.

We’re investigating the possibility of passing the conversation to one of our trained helpline advisors in situations like these. The aim would be for the conversation to continue through the virtual assistant, maintaining the anonymity that some people prefer, but the advisor would be equipped with the information provided during the rest of the conversation to understand what kind of support they might need.

Providing extra information

The virtual assistant has been taught about many topics, including drugs, exercise and pain management, but there’s still a great deal of information that it doesn’t know about and consequently, this means a lot of ongoing development.

Although the tool is aimed at people with arthritis, the implications for other audiences including healthcare professionals are great as there is the potential for it to contribute to professional development. It also has the potential to help support research by identifying patterns within data, which could help improve drug treatments and our understanding of arthritis. AI isn’t the future – it’s already here.

Find out more or chat to the virtual assistant.

A new resource aimed at all healthcare professionals, particularly GPs, launched in March 2019. Since the ‘fit note’ replaced the ‘sick note’ in 2010, most GPs have not received formal training or guidance in effectively using fit notes, nor has there been guidance around having conversations with patients about workplace modifications. To help this, DWP/DHSC Joint Unit for Work and Health commissioned Council for Work & Health to create a freely available resource.

The Talking Work guide is a free resource aimed at GPs and provides a simple checklist to the health and work conversation with patients. It gives examples of useful phrases to consider and signposts patients and employers to other useful resources (such as the Access to Work Scheme), that can provide funding for people with disabilities to stay in work.

The resource is an important step in supporting GPs to consider work as an outcome of their care. The themes and practical tips it introduces should build confidence in discussing workplace modifications with patients, and go some way to meeting the increasing calls from those with long term musculoskeletal conditions to remove their barriers to a fulfilling life, and this includes employment.

The Talking Work guide is available at www.councilforworkandhealth.org.uk/work-modifications/

Chronic shoulder pain lasting over 3 months is most commonly diagnosed as subacromial shoulder pain syndrome (SAPS), and negatively impacts on a patient’s ability to undertake everyday tasks.

Following first line treatments such as analgesics, exercise therapy and glucocorticoid injections, decompression surgery is frequently used for the treatment of longstanding SAPS and has become one of the most commonly performed surgical procedures in orthopaedics.

In this procedure, bony spurs and soft tissue are removed from the shoulder blade in order to prevent physical contact with rotator cuff tendons during arm movement, as this contact is proposed to be the source of pain in SAPS. Despite its prevalence, evidence for the benefits of decompression surgery has been limited, leading to inconsistencies in current guideline recommendations.

In recent years, high quality trials have been undertaken to investigate decompression surgery further, including the CSAW trial led by Professor David Beard at the University of Oxford. The trial, funded by Versus Arthritis, was the largest study to investigate the effectiveness of decompression surgery for shoulder pain, and the first to include a placebo comparison. The team found that decompression surgery did not provide an improvement in pain symptoms, and this has since been used by the BMJ to produce a Rapid Recommendation against decompression surgery.

The recommendation, published in February this year, was produced by a guideline panel of patients, clinicians and methodologists. By performing systematic reviews of published trials, they found that decompression surgery did not provide clinically important improvements in symptoms, but it does increase the risk of harm, as frozen shoulder is more commonly experienced following surgery.

They conclude that subacromial decompression surgery should not be offered to patients with SAPS, and encourage healthcare professionals to educate the public on the ineffectiveness of surgery.

More information can be found in the published article here.

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