This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.
  • The Arthritis and Musculoskeletal Alliance (ARMA) is the umbrella body for the arthritis and musculoskeletal community in the UK, and our mission is to transform the quality of life of people with musculoskeletal conditions. We have 33 member organisations ranging from specialised support groups for rare diseases to major research charities and national professional bodies.

Research

The Fracture Liaison Service Database Annual report 2020, published in January by the Royal College of Physicians, provides the third national benchmark for the performance of FLSs at the patient level.

There were 58,979 of an expected 322,660 patients who sustained a fragility fracture in 2018 across England and Wales were reported on in the Fracture Liaison Service Database (FLS-DB). The FLS-DB used eleven key performance indicators (KPIs) for this report to measure secondary fracture prevention.

With over 300,000 fragility fractures in England and Wales detected every year in patients aged 50 years and over (NHFD, 2019), secondary fracture prevention is more important than ever. The FLS-DB is still the only national secondary fracture prevention patient-level audit in the world, with 69 FLSs having submitted patient data from over 180,000 patients across the NHS in England and Wales.

Key Findings and Recommendations

With an increase of data completeness since 2017 and 63% of FLSs improving in at least one KPI, the FLS-DB encourages steady but rapid growth in the general monitoring of FLSs and their participation in the FLS-DB with an initiative to improve regular interaction. The importance of the commissioners and local health boards’ involvement in the effectiveness of their FLSs are more significant than ever. The FLS-DB is a resource for all FLSs, alongside NHS Trust and Health Boards to improve the effectiveness of post-fracture care delivery and reduce the number of preventable fragility fractures in this high-risk patient group. It is encouraging to see the constant improvement, but more still needs to be done to meet the needs of people with fragility fractures. The FLS-DB have produced an online improvement repository with a breakdown of the KPIs used for this year’s report, alongside a series of resources available for all to utilise and refer to. In order to support FLS teams with quality improvement, the ROS has developed a continuous quality improvement toolkit, helping to drive delivery of best and effective care for people with osteoporosis.

Read the full FLS-DB annual report.

The Quality in Osteopathic Practice report brings together existing research around the patient experience with research on clinical effectiveness and the safety of osteopathic practice.

Full of useful statistics and information, the report is relevant to anyone who has an interest in finding out more about osteopathic practice and the evidence that there is available, whether as a patient or a member of the wider general public, a private or NHS commissioner of service or other colleagues in healthcare.

Read the Quality in Osteopathic Practice report from the Institute of Osteopathy.

Can you help us improve healthcare for people with fibromyalgia in the UK?

Professor Gary Macfarlane and Dr Rosemary Hollick of the PACFiND study team are looking for healthcare professionals who see patients with fibromyalgia to take part in a short online survey.

This survey will help PACFiND understand current provision of NHS services for people with fibromyalgia.

PACFiND (PAtient-centred Care for Fibromyalgia: New pathway Design) is a project aimed at developing new pathways of care for people with fibromyalgia. 

Please click here to complete this survey. Thank you for your help.

iO report into primary care MSK MDT management following osteopathic assessment.

The Institute of Osteopathy (iO) has published a new low back pain case study. The report investigates effective multidisciplinary team management and sciatica in a primary care setting, following osteopathic assessment.

Read more on the iO website.

In October 2019 a report on chronic pain services and management from a patient and healthcare professional perspective was published. The research has highlighted a number of key insights and themes for how respondents felt that chronic pain services can be improved and made more equitable in the future. Pain is one of the common factors across all MSK conditions, so this is something which ARMA will be following up in the future.

This report describes the results of qualitative interviews with 23 patients and 20 healthcare professionals. All the patients had and MSK condition and had experienced pain for a minimum of 3 months. All the healthcare professionals had responsibility for managing patients with chronic pain.

The report highlighted a number of key insights:

  • Living with chronic pain affects all aspects of a patient’s life – it places a huge burden on patients, exacerbated by a lack of clear answers about how best to manage daily life
  • Patients often face delays and setbacks when trying to gain access to appropriate treatments and healthcare support services
  • GPs also face hurdles at almost every stage of treating and managing chronic pain and are aware that there are inconsistencies that vary from location to location across the country
  • Access to specialist pain services is difficult and is inconsistent across the UK
  • Overall satisfaction with support for chronic pain is fairly poor and patients have mixed experiences of services

Read the report

The National Early Inflammatory Arthritis Audit (NEIAA) collects information on all new patients over the age of sixteen seen in specialist rheumatology departments with suspected inflammatory arthritis in England and Wales. The first report was published in October. The audit assesses seven key metrics of care provided for people with new symptoms of arthritis attending rheumatology services for the first time and makes recommendations for services, educators and commissioners.

Some of the key findings include:

  • Secondary care units take an average of 28 days to achieve first assessment, compared to a target of three weeks.
  • There have been significant reductions in treatment delay, but disease-modifying anti-rheumatic drug (cDMARD) treatment is still only initiated within six weeks of referral in 54% of patients.
  • Access to psychology services is limited across all regions.
  • Patients with axial spondyloarthritis (axial SpA) tended to have substantially greater symptom duration prior to assessment.
  • Nearly a third of patients reported significant work impairment at presentation due to their symptoms. This improved over the first three months of care.

For full details of the findings and recommendations see the report on the Healthcare Quality Improvement
Partnership website.

 

 

by Liz Lawrence, Head of Health Service Improvement, Versus Arthritis

Versus Arthritis has a rich research heritage and has funded some great research that has advanced practice including ESCAPE-pain or ‘Enabling Self-management and Coping with Arthritis Pain through Exercise’. This is a six-week rehabilitation programme for people aged 45+ with persistent hip and/or knee osteoarthritis. ESCAPE-pain involves group education and exercise delivered over twelve sessions. The ESCAPE-pain programme was originally developed by Professor Mike Hurley [1] with funding from Arthritis Research UK (now Versus Arthritis).

But how do we move from funding research to making the research a reality for people with arthritis? It is often cited that it can take 17 years for research findings to find their way into practice [2].

This is why Versus Arthritis entered into a 3-year partnership with the Health Innovation Network in South London, with Professor Mike Hurley, their MSK Clinical Director to learn and test approaches for scale up.

We are keen to share our learnings so far, having worked across a further two Academic Health Science Networks and an Active Partnership. We were supported in the learning through external evaluation from Brightpurpose.

We now have a better understanding on some of the challenges and opportunities to spread innovations such as ESCAPE-pain. We think others will be interested in this too, so we are providing highlights of our learning as well as sharing case studies from the three sites we worked with.

The report can be accessed and downloaded here, and for more information about ESCAPE-pain contact: hello@escape-pain.org. To find out more about this report or the ground breaking work of Versus Arthritis, then please contact: healthservicesimprovement@versusarthritis.org

Footnotes
[1] Intellectual Property for the programme resides with the Health Innovation Network (hosted by Guys and St Thomas’ NHS Trust), Kingston University and St George’s, University of London
[2] Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011;104(12):510–520. doi:10.1258/jrsm.2011.110180

by Sophia Steinberger, Health Intelligence Analyst and Jonathan Canty, Policy Officer, Versus Arthritis

How many people have musculoskeletal conditions in the UK? How are these conditions affecting their lives? What is the breakdown by age, gender, and condition? What is the impact of MSK conditions on work, health services, and the wider economy?

This month Versus Arthritis published the annual State of Musculoskeletal Health 2019 to help answer these questions and many more. The report presents a collection of the best available data on the prevalence, risk factors, comorbidities, and impact of MSK conditions in the UK, to help further the understanding about the people living with and affected by these conditions.

Musculoskeletal (MSK) conditions such as arthritis and back pain affected an estimated 18.8 million people across the UK in 2017. They accounted for more than 22% of the total burden of ill health (morbidity) in the UK, and low back and neck were the biggest cause of ill health overall across all ages.1 While these conditions are incredibly common, many people affected are still not receiving the recognition and support they deserve and need.

The State of Musculoskeletal Health is a resource for health professionals, policy makers, public health leads and anyone interested in MSK health. We believe that with the best information you can build awareness, make more informed decisions, feel more confident and ultimately help more people with MSK conditions.

Read the full report here, which includes powerful short stories from people with arthritis themselves.

1 Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017) Results. Institute for Health Metrics and Evaluation (IHME), Seattle, 2018.