This is a category taken from the full feed of Musculoskeletal and Arthritis news provided by ARMA's members.

Treatments & Therapies

Recently, Arthritis Research UK has launched another round of Spark funding in collaboration with the Design Council. The Spark programme provides funding and support to UK-based innovators to develop products that will help tackle the everyday challenges that people with arthritis face, so improving their quality of life.

This exciting initiative aims to support the development of assistive products that help people living with arthritis and musculoskeletal conditions to live well, to help people be independent and to be in control of their lives as much as possible.

This year’s Spark 2017 awardee, Geoff Rolandsen, developed Workey, a key-turning tool designed to help individuals with reduced hand dexterity to open and lock doors. Other supported products include Kikka Digga, a back-saving attachment that fits onto garden forks and spades and Spark 2016 awardee Handy-Fasteners, who developed a set of magnetic fasteners that attach to clothing to remove the hassles often associated with traditional buttons.

Entry for Spark 2018 is now open.

ESCAPE-pain is a 6 week rehabilitation programme for individuals with knee and hip osteoarthritis which aims to educate participants on their condition, self-management and coping strategies as well as exercise. The Health Innovation Network, the Academic Health Science Network, has been working hard for the past 3+ years to spread the adoption of ESCAPE-pain across the U.K, and recently, has been awarded a grant by Sport England as part of their ‘Active Ageing’ project to target inactive adults in particular and increase access to the programme.

As part of our preliminary research efforts to identify new potential settings in which to deliver ESCAPE-pain, we have put together a very short survey of only 6 questions, to try and understand potential user preferences. If you are an adult aged 55+ and have experience of living with osteoarthritis, or any other exercise restricting condition, we would really appreciate it if you could take just 3 minutes to complete it by following this link: www.surveymonkey.co.uk/ESCAPEpain.

The survey will not ask any personal questions, and will be kept completely anonymous.
For more information please visit our website.

The British Orthopaedic Association (BOA) is pleased to announce the recent publication of four revised commissioning guides with the Royal College of Surgeons of England. These NICE-accredited guides set out best practice care pathways to assist CCGs in designing optimal care for their populations. We are extremely grateful to all those involved in the rigorous development and accreditation processes. The guides, which can be found here, are:

  • Pain Arising from the Hip in Adults
  • Painful Deformed Great Toe in Adults
  • Painful Osteoarthritis of the Knee
  • Treatment of Carpal Tunnel Syndrome

Following the recent BOA and ARMA position statements on the rationing of elective orthopaedic services, we are urging stakeholders to consider these guides and to promote their adoption wherever appropriate with local CCGs. The use of these guides will assist CCGs to deliver high quality care in each of these pathways.

If you have any further questions, please contact policy@boa.ac.uk.

In late September, BSR are releasing ‘A Guide to Rheumatology: Parliamentary briefing,’ which seeks to address the challenges and opportunities faced by the rheumatology multidisciplinary team and identify ways to improve the treatment and care received by individuals with rheumatic and musculoskeletal diseases. It highlights the significant difficulties experienced by rheumatology services and the patients they serve: 

  • Waiting times: 38% of patients in England with suspected rheumatoid arthritis were assessed within three weeks of referral.
  • Diagnostic delay: Only 18% of patients in England were referred to rheumatology within the NICE recommended three days of presentation to their GP.
  • Workforce: In England, there are 0.84 consultant rheumatologists per 100,000 of the population, which is below the Royal College of Physicians recommendations of 1.09.

You can access the document via the BSR Briefings page.

The briefing also highlights a range of recommendations to improve treatment for rheumatology patients – among them, adherence to NICE Guidelines and Quality Standards and best practice as a target for performance, increasing the requirement of the rheumatology MDT, and reviewing collaboration between GPs and rheumatology services.

Also look out for BSR’s Northern Ireland report, due to be published on the 12th October.

In early August, ARMA has published a Policy Position Paper titled:

‘Rationing’ Access to Joint Replacement Surgery and Impact on People with Arthritis and Musculoskeletal Conditions [document opens in pdf]

It deals with the damaging nature of thresholds and scoring tools, the problems of waiting times and restricted access to surgery, and how patients with musculoskeletal conditions are affected.

The Alliance is drawing attention to worrying trends in treatment access and the paper makes clear the key outcomes we are seeking from CCGs and the NHS.

In July LUPUS UK released the newest edition in their range of publications, ‘LUPUS: Bone Health & Osteoporosis’.

The factsheet was kindly written by Dr David Armstrong (Consultant Rheumatologist, Altnagelvin Hospital, Londonderry).

This factsheet can be downloaded from the LUPUS UK website at www.lupusuk.org.uk/publications/ and physical copies are available from the National Office in Romford.

The current delay to diagnosis of ankylosing spondylitis (AS) stands at 8.5 years. NASS are committed to reducing this delay to diagnose. There are many factors impacting on this delay but an important issue is the recognition of AS in primary care and prompt referral on to rheumatology.

NASS have worked in partnership with the British Society for SpondyloArthritis (BRITSpA) to sponsor an eLearning course on ankylosing spondyloarthritis (axial spondyloarthritis) (AS) on the Royal College of General Practitioners (RCGP) website. The course aims to educate GPs about AS. There are two parts to the course, the first part covers diagnosing AS and the second covers how AS should be managed.

It was authored by Dr Karl Gafffney, consultant rheumatologist at the Norfolk and Norwich Hospital and NASS trustee and Dr Daniel Murphy, who works both as a rheumatologist at the Royal Devon & Exeter Hospital, and a GP in Honiton.

GPs and any other health professional can access the course free of charge by signing up on the RCGP website. We really hope this course will help health professionals understand more about AS and, over time, reduce the long delay to diagnosis.

 

On 10th July 2017, NICE issued a new Technology Appraisal (TA) for bisphosphonates which links the recommendations for drug treatments to advice on fracture risk assessment outlined in their earlier guidance. The TA is not intended to provide treatment thresholds but offers recommendations on cost-effective use of bisphosphonates when using fracture risk assessment as described in their guideline www.nice.org.uk/guidance/cg146.

For the first time, these recommendations will apply to men as well as women.

The TA says that provided an individual meets the criteria for fracture risk assessment there should be no financial barrier to them receiving bisphosphonates if they have a fracture risk of at least 1% using FRAX or QFracture. If that person does not get on with an oral treatment, intravenous (IV) bisphosphonates can be given instead.

Anne Thurston, Head of Policy at National Osteoporosis Society, says, “We welcome this clear guidance from NICE which says that cost will not be a barrier to these treatments for people at risk of a fracture from osteoporosis. Doctors need to look at a number of risk factors when they decide whether somebody would benefit from taking a medicine, and discuss the risks and benefits for that person.

“Now that NICE has issued this appraisal, we need to make sure that doctors are given the information they need to support their decisions about which patients need a treatment. Osteoporosis and fractures cause pain, disability and loss of independence and as a charity we are dedicated to ensuring that people have the care and support they need to live well with the condition. This MTA is a useful step in the right direction in the fight against broken bones.”

If a doctor wants to prescribe IV bisphosphonates without first trying an oral treatment, their fracture risk needs to be at least 10% using FRAX or QFracture.

Non-bisphosphonate treatments for osteoporosis will be reviewed by NICE in a separate piece of work which has not yet begun.

The NHS is legally obliged to fund treatments recommended by NICE’s technology appraisals – patients now have the right to these treatments, if their doctor believes they are clinically appropriate.

Health professionals will be required to make treatment decisions in a landscape with contradicting clinical guidance. For those who use the online tool FRAX to assess risk, NICE have signposted NOGG for more information about appropriate treatment thresholds.  The SIGN guideline on osteoporosis applies in Scotland and also offers sensible, evidence-based recommendations.

The full technology appraisal is available online at: Multiple Technology Appraisal (MTA) on the use of bisphosphonates.

 

NOS Events in late 2017

National Osteoporosis Society is holding a number of events for health professionals in the coming months.

  • 5th October 2017: Northern Ireland Osteoporosis Conference 2017
  • 12th October 2017: Wales Osteoporosis Advisory Group – Skills and Knowledge Workshop
  • 30th November: Osteoporosis Clinical Update (Birmingham)

To view more details and register for these events, some of which are free, please visit nos.org.uk/health-professional-events/.