Self-management - underpinning theme

Leader: Professor Sarah Hewlett, with Drs Emma Dures, Karen Wallace, Fiona Cramp, Nicki Walsh and Nick Ambler

Overall aims

To establish evidence-based self-management support for people with musculoskeletal conditions, across both trusts and in the community. This will include equitable access to self-management support for patients across trusts, and the use of appropriate behaviour change approaches by staff.

Projects and activities

We are undertaking a scoping exercise of rheumatology self-management services across the two trusts, to facilitate equitable access across both trusts, extending into the community where appropriate. We are also working on equalizing the level of psychological support provision across both trusts.

In primary care, we have shown that group exercise programmes for lower limb osteoarthritis (OA), using a cognitive-behavioural approach, to enable people to self-manage is clinically- and cost-effective compared to standard GP care. Dr Nicki Walsh is working Bristol City Council and the clinical commissioning groups to explore ways of rolling this out.

Our research aims are to develop and test rheumatology team training in skills to enhance self-management during routine consultations, to make fatigue self-management support more widely available, and test exercise and activity interventions.

Research in progress

  • A randomized controlled trial of cognitive–behavioural approaches for the self-management of fatigue in rheumatoid arthritis, delivered by clinical teams, to groups of patients
  • Exploring the support needs of men with rheumatoid arthritis
  • Development of an activity intervention for fatigue in rheumatoid arthritis (RA)
  • Exploring the journey from diagnosis through the first year of life with inflammatory arthritis
  • Developing an intervention to promote physical activity by people with a recent diagnosis of rheumatoid arthritis
  • Exploring strategies that would be acceptable to people with RA for promoting physical activity
  • Developing a one-to-one fatigue intervention for people with RA


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