DEVELOPMENT OF A MODEL CONSULTATION AND TRAINING PACKAGE FOR PRACTICE NURSES TO SUPPORT SELF-MANAGEMENT OF PATIENTS CONSULTING WITH OSTEOARTHRITIS IN PRIMARY CARE

Healey, Emma L.; Ryan, Sarah; McHugh, Gretl A.; Main, Chris J.; Porcheret, Mark; Nio Ong, Bie; Pushpa-Rajah, Angela; Dziedzic, Krysia S.

Abstract

Background: In the UK OA is predominately managed in general practice. Evidence suggests practice nurses are the health professionals most likely to provide self-management support for patients with long-term conditions. Traditionally, practice nurses don't have a role in the management of OA, yet they may be best placed to offer core treatments recommended in the NICE OA guidelines. The MOSAICS study is the first to develop a system for delivering these core treatments through a linked GP-nurse model OA consultation (MOAC). The aim of this work was to develop the nurse-led element of the model OA consultation and a training package that provides practice nurses with the skill set needed to support and enable patients to self-manage OA in line with the NICE guidelines.

Methods: A literature search and mapping exercise of OA and chronic disease self-management programmes was conducted. Common elements were identified and along with the NICE OA guidelines the content of a model nurse-led consultation was developed. Initial feedback on content was obtained from a practice nurse advisory group and an OA research user group. Once the model consultation was agreed, a training package was developed to provide the nurses with the knowledge and skill set needed. The training package was piloted with 5 nurses; it was then refined and delivered to 9 practice nurses. The training was evaluated via (i) trainer reflections (ii) real-time observations from trainers and trainees and (iii) formal daily evaluation by trainees.

Results: A 4 day training package was developed to enable practice nurses to deliver the model OA consultation (up to 4 x 20–30 min appointments over 3 months). The model consultation and training focused on encouraging a patient centred approach and used a specially developed OA guidebook, goal setting, pain management and the core NICE recommendations (information and advice, exercise and physical activity and weight management) to support self-management. Evaluation of the pilot training resulted in theoretical material being reduced significantly; allowing more time to be dedicated to experiential elements (role play and simulated patient sessions) and having an experienced facilitator lead the training. Evaluation of the refined package demonstrated that the OA guidebook needs to be better integrated with the consultation and more time dedicated to practising joint examination and demonstration of exercise.

Conclusions: Traditionally, OA management is not seen as a high priority for primary care and patients believe that little can be done. The NICE guidelines highlight the therapeutic gains of self-management and the development of a nurse-led model consultation and training package goes some way to develop a system in primary care for delivering positive messages about what can be done for OA and the recommended core treatments.

Disclosures: K.D., Arthritis Research UK—Programme Grant. E.H., Arthritis Research UK—Programme Grant. C.M., Arthritis Research UK—Programme Grant. B.O., Arthritis Research UK—Programme Grant. M.P., Arthritis Research UK—Programme Grant. A.P., Arthritis Research UK—Programme Grant. All other authors have declared no conflicts of interest.

Citation

Healey, E. L., Ryan, S., McHugh, G. A., Main, C. J., Porcheret, M., Nio Ong, B., …Dziedzic, K. S. (2013, April). DEVELOPMENT OF A MODEL CONSULTATION AND TRAINING PACKAGE FOR PRACTICE NURSES TO SUPPORT SELF-MANAGEMENT OF PATIENTS CONSULTING WITH OSTEOARTHRITIS IN PRIMARY CARE. Paper presented at Rheumatology 2013, Birmingham, England, UK

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: Rheumatology 2013
• Conference Location: Birmingham, England, UK
• Start Date: Apr 23, 2013
• End Date: Apr 25, 2013
• Deposit Date: Oct 17, 2023
• Publisher URL: https://academic.oup.com/rheumatology/article/52/suppl_1/i33/1929284