November 2017 network news

Helpline

Since our Helpline launched in April we have spoken to nearly 7000 people affected by arthritis. Our trained advisors can provide a personalised information and advice support service where they can discuss each caller’s unique situation and help people understand and digest the information as well as signposting to other organisations. Conditions and treatment remain the most common reason for contacting us, with osteoarthritis and rheumatoid arthritis being the most common conditions.

Arthritis Virtual Assistant

We have also been working with IBM using artificial intelligence to develop a new information tool available on our website, which allows people with arthritis to ask questions and have a conversation about their information needs, at any time in the day or night via a chatbot.

Our Arthritis Virtual Assistant can answer questions on exercise, drugs, pain management and all types of arthritis. Since August, over 8000 people have engaged with the chatbot and the most common themes are; the side-effects of drugs, pain and exercise.

Joint Understanding

We are very excited to announce the launch of our Joint Understanding programme for people with arthritis who are undergoing a knee or hip replacement. The programme is led by trained peers and aims to provide people with support, practical tips and information to help them before and after their joint replacement. Each peer group will be provided with a selection of topics relating to joint replacement which will help to stimulate group discussions and provide a framework for conversations. We are testing Joint Understanding for 12 months in 4 areas of the UK: Exeter, Middlesbrough, Sheffield and Crewe. We have already trained the first cohort of peers who will run the groups in Exeter and hope to begin setting up peer group meetings over the coming weeks. So that we can understand the difference our programme is making to people with arthritis, we will be working with an external evaluator who will be supporting us to design and conduct the evaluation in each of the 4 areas.

If you would like to find out more information about our Joint Understanding programme, please contact Anne Kelleher on a.kelleher@versusarthritis.org or phone 07854273403.

The helplines are open from 9am-8pm, Monday- Friday (excluding bank holidays). Please note that our advisors are not medically trained and aren’t able to offer you individual medical advice. We recommend that you speak with your GP or another healthcare professional for one-to-one medical advice. Calls may be recorded for training purposes.

We’re excited to announce that the new and improved Musculoskeletal Calculator prevalence mapping tool is now live for you to use. This is a huge step towards filling the MSK information gap and making this information readily available. The updated tool provides health professionals and planners with the most accurate and up-to-date prevalence estimates for osteoarthritis (hip/knee), back pain and rheumatoid arthritis in England and Scotland at local authority (LA), Clinical Commissioning Group (CCG) or Health Board level. The tool can be used to search, compare, and download prevalence estimates for local areas. These estimates should be used to inform joint strategic needs assessments, service planning and prioritisation in local areas.

The Arthritis Research UK Centre for Adolescent Rheumatology is the world’s first centre dedicated to understanding arthritis in adolescents. In partnership with Great Ormond Street Hospital, University College London and University College London Hospital, and with funding also provided by Great Ormond Street Hospital Children’s Charity (GOSHCC), research at this centre explores how and why arthritis affects this age group. One of the projects that the centre is currently working on (co-funded by the Health Foundation) involves the use of a self-management smartphone app (JIApp) to allow young people with juvenile idiopathic arthritis to self-monitor their disease activity and side effects, and ultimately engage with their healthcare.

The application also allows young people with the condition to access educational information and social support forums, as well as the option to receive treatment-related reminders. The researchers hope that using the app can increase a patient’s understanding of their arthritis, promote self-management, and improve the quality of information available to their doctor. The app was designed and developed alongside both young people with the condition, parents of those with the condition, and healthcare professionals. The researchers recently published on this work, in which they found the acceptability and usability of JIApp, to be high for both young people with juvenile idiopathic arthritis and healthcare professionals. The next steps will be a long-term testing of the app to study the effect on outcomes, as well as the cost-effectiveness of using this type of system.

To find out more or if you have any questions please visit the centre for adolescent rheumatology’s website.

We regularly hear from people living with osteoarthritis, who share with us the impact their condition can have on reducing mobility and independence, while also negatively affecting wellbeing and quality of life. For people with severe osteoarthritis, joint replacement surgery can be very effective at reducing pain and restoring independence.

Despite this, we know that throughout the country increasing numbers of people are waiting longer than the 18 week target before beginning consultant led treatment for joint replacement surgery. In addition, there have also been reports that in some areas, criteria have been introduced stating that patients with a larger body mass index will have to lose a percentage of their weight before they can be referred for elective surgery, or wait up to 12 months to have the operation. We believe that people’s access to surgery, which can significantly improve people’s quality of life, should be based on their clinical need and their own preferences, following an individual assessment by an orthopaedic surgeon.

Our policy and public affairs team have been focusing on this area, and working to ensure that no one with arthritis is unable to get the treatment they need, regardless of where they live in the UK. We have been working with colleagues from the Arthritis and Musculoskeletal Alliance including the Chartered Society of Physiotherapists and the British Orthopaedic Association on a sector-wide approach to this issue that reflects the positions of both patient representative organisations and professional bodies.

1. Can you tell us what health-coaching is?

Health-coaching is a skill that can be learnt and brings together, clinical knowledge, behaviour change science (motivational interviewing, CBT etc) and techniques for patients to fully participate in their healthcare. The aim of coaching is for people to gain confidence to think well for themselves in order to improve self-management, which is vital in any long-term condition.

2. Why might a health coaching approach be appropriate/beneficial for patients with MSK conditions?

The traditional ‘medical model’ of healthcare does little to address the issues of those living with persistent MSK pain. Sadly, self-management is often only advocated as a last resort, when ‘medicine’ has failed. Health-coaching skills tap into the resourcefulness of the person with the MSK condition to understand and accept the significant contribution they can make, from the outset.

People who are more ‘activated’ (knowledgeable, skilful and confident to self-manage) partner in their care and report a better QoL. A coaching approach is ideal to increase ‘activation’ and puts the patient firmly in the driving seat (as much as they are able).

3. How does this approach benefit the HCP?

With increasing demands and dwindling resources, providing healthcare in the way that we have done, is not an option. Activated patients, partner in their care and take more responsibility for their health. In this way, the burden on the health service and the practitioners working in it, is eased. One ‘penny-drop’ moment that has sustained me working in the NHS, is the realisation that, ‘It’s not all about me!’ My job now is more about coaching patients to find their own ability-to-respond to their health condition. In my view, this is not about cost effectiveness – it’s always been the right (and most rewarding) thing to do.

4. This all sounds great, but I’m a GP and only have a ten minute appointment with my patients – how can I adopt this approach in my practice?

Health coaching cannot be about doing more in an already stretched consultation. Rather, it is a way of being, that skilfully encourages more active participation from our patients. It might feel quicker just to tell or advise people on lifestyle changes, but that just increases dependency on you and the system. More importantly, it misses the best and most sustainable solutions, that people can come up with for themselves.

Dr Tim Williams is a GP, community pain specialist and professional Time to Think life-coach, based in Sheffield. He is co-director of Peak Health Coaching Ltd, which trains HCPs in health-coaching and author of ‘Don’t Just STOPIT.DOIT’ – a coaching book for patients and professionals alike.

Peak Health Coaching are Insignia Health’s preferred training provider, in the UK, for the Patient Activation Measure (PAM®).