Directors Dr Emma Clark, Associate Professor Emma Dures and Mr Sanchit Mehendale give an update on the 2018-19 activity of the Bristol Bones and Joints Health Integration Team (HIT).
Bristol Bones and Joints is interested in research and healthcare for all patients with musculoskeletal diseases, osteoporosis and arthritis. We meet regularly to try and improve care for our patients across Bristol by using the latest research and international expert views to make sure we are providing high quality care.
We are particularly interested in self-management. Self-management includes all the ways that patients deal with their health, including their symptoms and treatments, and the social and emotional effects of living with a musculoskeletal condition. Healthcare professionals and researchers can help with self-management by understanding what is important and what is helpful to patients.
One example is fatigue, which patients identified as one of the most difficult symptoms to cope with. We have tested a group programme aimed at reducing the impact of fatigue on patients’ daily lives. The results showed that patients found the group programme helpful, and we are now exploring ways of rolling it out across the region.
We are also looking at the social and emotional support that is available in rheumatology, as patients have told us that this is an aspect of their care that is important but not always available.
We now know that early diagnosis and treatment is essential in rheumatoid arthritis (RA). By seeing people quickly, we can start the right treatment and aim to get symptoms of pain, stiffness and fatigue under control. Long-term outcomes such as joint damage and health-related quality of life can also be improved.
We have worked together with Bristol general practitioners (GPs) to develop shared referral protocols for early inflammatory arthritis for GPs. This should ensure that the patients in most need are prioritised and seen quickly in rheumatology departments across Bristol and Weston-super-Mare.
Monitoring of treatments for RA is shared between rheumatology departments and patients' GPs. We have developed shared care guidelines for GPs across Bristol about how to monitor their patients, such as appropriate blood tests and when to withhold or continue medications or contact their rheumatologists. This should help to support patients by having a common approach across primary and secondary care.