Bristol Bones and Joints HIT looks back over 2018-19

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.