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Found 33 results
  1. Content Article
    Airing Pain is a podcast from Pain Concern. Each edition brings together people in pain and top specialists to talk about resources that can help. This edition investigates the significant inequalities and disparities in treatment among primary care pain management services. It features the following participants: Professor Jonathan Hill, Director of Research for the School of Allied Health Professionals and Professor of Physiotherapy at the Keele School of Medicine; Dr Ama Kissie, post-doctoral fellow at the University of Ghent and a Clinical Psychologist; Dr Whitney Scott, clinical psychologist who lectures at Kings College London and is the research lead at the INPUT Pain Management Unit at Guy’s & St Thomas’ Hospital.
  2. Content Article
    People taking methotrexate (for inflammatory conditions such as rheumatoid arthritis) have regular blood tests to check for certain side effects. Researchers have developed a tool to predict the likelihood of them discontinuing methotrexate due to these side effects, which could in future lead to less frequent testing for most people (68%) on methotrexate. The tool uses information routinely collected by GPs. The study found that it could predict people’s risk of discontinuing methotrexate because of side effects. It was accurate for most people across different ages, inflammatory conditions, methotrexate doses and routes of administration. The researchers say the tool could in future be used by GPs to identify people who need more or less frequent blood tests. This article refers to the original research study Risk stratified monitoring for methotrexate toxicity in immune mediated inflammatory diseases: prognostic model development and validation using primary care data from the UK
  3. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Benjamin talks about why we need a radical shift in how we view and treat people with chronic pain and how over-investigation and over-treatment compromise patient safety. He also talks about the power of communal singing for people with long-term conditions and what wild swimming has taught him about supporting people living with chronic pain.
  4. News Article
    Hundreds of rheumatology patients have stopped receiving drugs they did not need or had their diagnosis changed after a damning review of the service found the standard of care was “well below” what would be considered acceptable. Jersey’s Health and Community services department has said it will be contacting some of the affected patients “over the coming weeks” and would also be seeking legal advice on “an appropriate approach to compensation”. The independent review by the Royal College of Physicians also noted there was “no evidence” of standard operating procedures for most aspects of routine rheumatological care and, in some cases, “no evidence of clinical examinations”. It also found that there had been incorrect diagnosis and wrongly prescribed drugs, describing the standard of care as “well below what the review team would consider acceptable” for a contemporary rheumatological service. The review was commissioned by HCS medical director Patrick Armstrong, following concerns raised by a junior doctor in January 2022. Read full story Source: Jersey Evening Post, 22 January 2024
  5. News Article
    Health experts say more attention should be given to patients’ experiences after research found multiple examples of their insights being undervalued. A study led by the University of Cambridge and King’s College London found clinicians ranked patient self-assessments as the least important when making diagnostic decisions. Ethnicity and gender were felt to influence diagnosis, particularly a perception that women were more likely to be told their symptoms were psychosomatic. Male clinicians were more likely to say that patients overplay symptoms. The findings prompted calls for clinicians to move away from the “doctor knows best attitude” when caring for patients. One patient shared the feeling of being disbelieved as “degrading and dehumanising”, and added: “I’ll tell them my symptoms and they’ll tell me that symptom is wrong, or I can’t feel pain there, or in that way.” Read full story Source: The Guardian, 18 December 2023
  6. Content Article
    In a study published in Rheumatology, researchers used the example of neuropsychiatric lupus, an incurable autoimmune disease that is particularly challenging to diagnose, to examine the different value given by clinicians to 13 different types of evidence used in diagnoses. This included evidence such as brain scans, patient views, and the observations of family and friends.
  7. Content Article
    This blog by the British Society for Rheumatology (BSR) shares highlights of the evidence given to a House of Lord's inquiry into homecare medicines services' governance and accountability. The witness sessions heard evidence on levers for accountability, performance and safety, e-prescribing and workforce. The blog looks at challenges faced by providers, the need for improved regulation and accountability and lack of data and KPIs. It also describes a desktop investigation being undertaken by NHS England to understand the range of arrangements that are in place and how homecare medicines services are held to account.
  8. Content Article
    During the pandemic, approximately 4.1 million people across the UK were identified as clinically extremely vulnerable (CEV) to Covid-19, and asked to shield for their own protection. This decision, made in the light of an unprecedented pandemic, would separate those with autoimmune inflammatory conditions, such as rheumatoid arthritis, from the rest of society for their own protection. This report by the charity Versus Arthritis presents qualitative research led by Dr Charlotte Sharp, a consultant rheumatologist, Lynn Laidlaw who has an autoimmune rheumatic disease and had to shield, and patient contributor Joyce Fox from the Centre for Epidemiology at the University of Manchester. It highlights the stories of people who lived through shielding and details the impact on their daily lives, their physical and mental wellbeing, their work, and their relationships with their families and the rest of society.
  9. News Article
    Patients with rheumatic conditions who shielded during the pandemic feel "left behind", according to new research. The University of the West of England (UWE) in Bristol conducted a study with patients about their experiences of shielding during the pandemic and how it continued to affect them. Researchers interviewed 15 rheumatology patients from the Bristol area. Pamela Richards, who suffers with arthritis, said the pandemic has been "a massive blow" to the way she lives. "I have never experienced anything like shielding, it heightened a sense of anxiety in me," said Ms Richards. "How do I get food? I cannot leave the house. How can I see friends? I was not allowed to." Ms Richards, who shielded for nearly two years during the pandemic, said that life has not returned to normal, despite no longer being advised to shield. "It is a new normal, which is about being on high alert and managing risk every day," she said. Researcher Christine Silverthorne said: "Many are still dealing with lasting physical and mental effects both from the experience of shielding and as a consequence of delays to their healthcare and treatment". Read full story Source: BBC News, 6 March 2023
  10. News Article
    The NHS in England is set to have a major conditions strategy to help determine policy for the care of increasing numbers of people in England with complex and often multiple long-term conditions. Conditions covered by the strategy will include cardiovascular disease, chronic respiratory disease, dementia, mental health conditions, and musculoskeletal disorders. Cancer will also be included and will no longer have its own dedicated 10 year strategy. England’s health and social care secretary, Steve Barclay, told the House of Commons on 24 January that the strategy would build on measures in the NHS long term plan. Read full story (paywalled) Source: BMJ, 25 January 2023
  11. Content Article
    Disease-modifying antirheumatic drugs (DMARDs) are a group of medications commonly used in people with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus (SLE). They work by work suppressing the body's overactive immune and/or inflammatory systems and take effect over weeks or months. This information guide gives information for patients on conventional and biologic DMARDS, including how they work, the different kinds available and their side effects.
  12. Content Article
    This study in the journal Rheumatology looked at the experience and views of rheumatology patients and clinicians regarding telemedicine. The Covid-19 pandemic has forced a rapid transition towards telephone consultations, but there are still many research gaps in understanding the safety and acceptability of telemedicine.
  13. Content Article
    Getting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
  14. Content Article
    In this blog, Lotty Tizzard, Patient Safety Learning's Content and Engagement Manager, looks at how positive, proactive communication improves patient trust in health services. She highlights that negative past experiences can prevent patients accessing the support and treatment they need, and looks at possible ways to build patient trust in the health system.
  15. Content Article
    The National Early Inflammatory Arthritis Audit (NEIAA) aims to improve the quality of care for people living with inflammatory arthritis, collecting information on all new patients over the age of 16 in specialist rheumatology departments in England and Wales. This NEIAA report presents data describing the association between ethnicity, experience of care and clinician and patient-reported outcomes. It found that Black, Asian and ethnic minority patients were less likely to achieve remission at three months (30% compared to 37%) and were more likely to report symptoms of anxiety or depression compared to white patients (33% compared to 30%), despite faster referrals and assessments than white patients.
  16. Content Article
    This report of a roundtable held by the Arthritis and Musculoskeletal Alliance (ARMA) highlights inequalities in relation to the prevalence of, and access to treatment for musculoskeletal conditions (MSKs). MSKs include a broad range of health conditions affecting the bones, joints, muscles and spine, as well as rarer autoimmune conditions such as lupus. Their incidence is correlated with deprivation, age, sex and ethnicity.
  17. Content Article
    Dalila, who lives in Cardiff, was diagnosed with systemic lupus erythematosus during childhood. In this blog for Lupus Awareness Month she talks about her experiences with the condition and the differences in the care she’s received between England and Wales.   The experience of people like Dalila is why the Rare Autoimmune Rheumatic Disease Alliance are calling for change in how people with rare autoimmune rheumatic diseases are cared for in Wales.  They are calling for: A properly commissioned specialised centre for rare autoimmune rheumatic diseases in Wales.  A network, where this specialised centre can support local hospitals to deliver better care.  Urgent action to resolve workforce issues in rheumatology in Wales.
  18. Content Article
    Despite their widespread use, the impact of commissioners’ policies for body mass index (BMI) for access to elective surgery is not clear. Policy use varies by locality, and there are concerns that these policies may worsen health inequalities. This study in BMC Medicine aimed to assess the impact of policies for BMI on access to hip replacement surgery in England. The authors used National Joint Registry data for 480,364 patients who had primary hip replacement surgery in England between January 2009 and December 2019. They found that rates of surgery fell after localities introduced policies restricting access to surgery based on BMI, whereas rates rose in localities with no policy. Localities with BMI policies have higher proportions of independently funded surgery and more affluent patients receiving surgery, indicating increasing health inequalities, and policies enforcing extra waiting time before surgery were associated with worsening mean pre-operative symptom scores and rising obesity. The authors recommend that BMI policies involving extra waiting time or mandatory BMI thresholds are no longer used to reduce access to hip replacement surgery.
  19. Content Article
    The Department of Health and Social Care is seeking views and ideas on how to prevent, diagnose, treat and manage the six major groups of health conditions that most affect the population in England. These are: cancers cardiovascular disease, including stroke and diabetes chronic respiratory diseases dementia mental ill health musculoskeletal disorders The views and ideas gathered will inform the priorities and actions in the major conditions strategy. The consultation will close at 11:59pm on 27 June 2023.
  20. News Article
    A drug used to treat rheumatoid arthritis appears to help patients who are admitted to intensive care with the most severe coronavirus infections, researchers say. Tocilizumab, a medicine that dampens down inflammation, improved outcomes for critically ill patients, according to early results from an international trial investigating whether the drug and others like it boost survival rates and reduce the amount of time patients spend in intensive care. The findings have not been peer-reviewed or published in a journal, but if confirmed by more trial data, the drug will be on track to become only the second effective therapy for the sickest Covid patients, following positive results for the steroid dexamethasone earlier this year. “We think these are very exciting results, we are encouraged by them,” said Prof Anthony Gordon, of Imperial College London, the UK’s chief investigator on the REMAP-CAP trial. “It could become the standard of care once we have all the data reviewed by guidelines groups, and also drug regulators.” Read full story Source: The Guardian, 20 November 2020
  21. Content Article
    This study in Best Practice & Research Clinical Rheumatology aimed to determine the systemic effects of surgical mesh implants. The study looked at patients referred to an autoimmunity clinic between January 2014 and December 2017 and concluded that mesh implants may increase the risk of developing autoimmune diseases by acting as an adjuvant (increasing the body's own immune response).
  22. Content Article
    Serious pathology as a cause of musculoskeletal (MSK) conditions is considered rare, but it needs to be managed either as an emergency or as urgent onward referral as directed by local pathways. This guidance supports primary and community care practitioners in recognising serious pathology which requires emergency or urgent referral to secondary care in a patient who present with new or worsening MSK symptoms.
  23. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Tony talks to us about making patient safety everyone’s responsibility, the importance of open communication and how his understanding of different global health systems has broadened his perspective on what matters in patient care.
  24. Content Article
    Decision support tools, also called patient decision aids, support shared decision making by making treatment, care and support options explicit. They provide evidence-based information about the associated benefits/harms and help patients to consider what matters most to them in relation to the possible outcomes, including doing nothing. NHS England has just published a suite of eight decision support tools that will help people with their healthcare professionals in clinical consultations, about their treatment choices for their condition through shared decision making. NHS England has worked with patients, patient charities health professionals and research teams over several months to develop the tools in line with NICE guidance on shared decision making standards.
  25. Content Article
    In the 2017 Health Survey for England, 34% of adults reported experiencing chronic pain. The survey found that 5.5 million people (12%) are affected by high-impact pain that prevents them from enjoying social, family and recreational activities, and from working, including carrying out household tasks. This document sets out what the Arthritis and Musculoskeletal Alliance (ARMA) believes should be available in every area for people living with long term pain. It covers four areas: Underpinning framework Treatment for underlying conditions Services for people living with chronic pain Prevention and inequalities
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