Focus on: self-care

Focus on: self-care I usually walk with a stick, but today I have come here without it Charles Oades, ESCAPE-pain patient Supporting our community to take positive steps towards better self-care C ore to our strategy is enabling people to live healthy lives. At Eastern AHSN, we continue to see the importance of self-care in patients ability to design and manage their own care and this desire will continue in our work moving forward. Here we have summarised some of the initiatives that, over the past year, have supported patients in adopting behaviour changes and taking positive steps towards self-care. Returning smiles to patients faces Osteoarthritis is the most common form of arthritis in the UK and affects almost a third (29%) of people over 45 in the East of England.1 Despite physical activity being one of the most effective treatment options, patients often avoid exercise for fear of damaging their joints further.2 Kelly-Marie Grant, Superintendent Physiotherapist at Cambridge University Hospitals NHS 238 Foundation Trust, said: We found that people believed that if their joints were sore they patients with osteoarthritis ESCAPE-pain completed the FACT ESCAPE-pain programme shouldnt exercise, but research has shown that exercise for joint pain is hugely beneficial. The old saying if you dont use it, you lose it definitely applies here. ESCAPE-pain is a national AHSN programme that helps address this issue and offers patients the reassurance and support they need to exercise safely over a sixweek exercise and education course. During 2019/20, there were 238 participants on the course across 17 locations in the Eastern region. Of those surveyed, more than two-thirds reported an improvement in their ability to take part in daily activities and 67% reported pain reduction. Charles Oades attends ESCAPE-pain sessions at Addenbrookes Hospital. His osteoarthritis means he needs to have a double knee replacement. He said: The system works. Ive only been coming to the classes for two weeks, but its already helped me so much. I usually walk with a stick, but today I have come here without it. My aim is to get back on the golf course, as Ive been unable to play since last year because of my condition. Importantly, its fun its a chance to meet people and exercise in a friendly environment. In addition to physical symptoms, two-thirds of people with osteoarthritis report depression when their pain is most severe. However, 62% of ESCAPE-pain participants surveyed in the Eastern region reported an improvement in quality of life following the programme. Jag Ahluwalia, Chief Clinical Officer from Eastern AHSN, said: ESCAPE-pain has made a great start in the Eastern region. According to the first reports from participants, the programme has demonstrated a clear An introduction to ESCAPE-pain clinical impact, bringing a reduction in pain and improvement in participants quality of life. Monitoring cardiac rehabilitation at home Regular activity is also one of the best ways for people to make a good recovery after cardiac surgery or a heart attack. However, research has shown that, nationally, only 52% of patients discharged from hospital after a heart attack sign up for the free NHS exercise programme and education.3 Aimed at the 26,000 people recorded as living with heart disease in Cambridge and Peterborough,4 integrated health monitoring programme Active+me was piloted in Cambridge and Huntingdonshire by Active+me: Embracing self-care - Maggies story Aseptika, in partnership with Eastern AHSN, to address this problem and drive greater adoption. The programme guides patients through safe and appropriate exercise but what makes this initiative different is that, alongside the classes, patients are given monitors to record their health metrics at home. These metrics are uploaded to an app, which is shared with their personal health coaches. It has made me understand what I can do for myself to improve my health and see and feel the positive effects Mark Fiddan, Active+me patient Mark Fiddan was the first patient to enrol on the programme via Addenbrookes Hospital. He said: Using the devices and app on my phone provided through the Active+me programme has enabled me to track and review my own health data with ease, so I can take an active role in managing my condition. Now when I meet my GP, I am so much more confident in talking about my health, arriving with all the information I need for an informed discussion. But over and above this, it has made me understand what I can do myself to improve my health and see and feel the positive effects. Driving patient confidence How can healthcare and fitness providers know whether referred activities, such as exercise prescriptions, are working to relieve pressure on the system, or providing value for money? With the support of Eastern AHSN, Active Suffolk set out to answer these questions by evaluating the impact on patients undergoing prescribed alternative treatment programmes over a three-month intervention period, with the total programme length spanning up to 18 months (September 2018 March 2020). The team used the Patient Activation Measure (PAM) to assess the extent participants were engaged and confident in taking care of their condition before and after taking part in the programme, and to demonstrate the impact of the service. The results showed that the participants activation levels were, on average, higher after completing their referral programmes. The team also found that understanding patients ability and motivation to self-manage illnesses, long-term health conditions or poor healthy living habits was a beneficial insight prior to starting Public Health England., (2020). Public Health Profiles [online]. Public Health England. [Viewed 24th April 2020]. Available from https://fingertips.phe.org.uk 1 Bricca, A. et al., (2019). Therapeutic exercise relieves pain and does not harm knee cartilage nor trigger inflammation. British Journal of Sports Medicine [online]. 54(2), 118. [Viewed 24th April 2020]. Available from doi http:// dx.doi.org/10.1136/bjsports-2019-100727 2 British Heart Foundation., (2018). The National Audit of Cardiac Rehabilitation: Annual Statistical Report 2017 [online]. [Viewed 24th April 2020]. Available from https://www.bhf.org.uk/ informationsupport/publications/statistics/ national-audit-of-cardiac-rehabilitationannual-statistical-report-2017 3 NHS Cambridgeshire and Peterborough Clinical Commissioning Group and Cambridgeshire County Council., (2015). Cardiovascular disease in Cambridgeshire and Peterborough CCG [online]. Cambridge Insight. [Viewed 24th April 2020]. Available from https:// cambridgeshireinsight.org.uk/wp-content/ uploads/2018/07/CCG-LTC-DataSupplement-2015.pdf 4 References Share this article behaviour-change intervention. In addition, raising patient activation levels could reduce the pressure on NHS services, improve quality and ensure that medical resources focus on patients with the most complex health needs. According to Nick Pringle, Senior Development Officer (Health & Wellbeing) at Active Suffolk: A major part of our Active Wellbeing service is to use behaviour change and motivational interviewing models in one-to-one consultations, to support patients to make positive changes towards a more physically active lifestyle. The PAM has helped us to evaluate our intervention by comparing the difference between PAM scores at baseline and three-month stages. Second, it has helped our project officers to tailor their conversations and language to best suit the type of patient they are seeing. This has helped streamline consultations, which has saved a lot of time and resources, which benefits the patient and staff. Managing mental health digitally Ipswich-based Moodwise provides young people (16-25) with preventative and crisis mental health support that is easily accessible, anonymous and cost-effective. The site, created by Mindwave, asks users simple questions to direct them to relevant support on anxiety, depression, stress, anger and loneliness. Over the past year, Eastern AHSN has supported the development of the Moodwise site, as well as the social media and paid-search campaigns vital to driving young people to the site. Since the collaboration was initiated, Moodwise has registered 3,585 new users. Almost twothirds (64%) of users came to the site from paid search and were mostly concentrated in East Anglia. Young people engaged most with the website, viewing more pages per session than any other group. In addition, while fewer males visited the site, those males that did visit it consistently viewed resources for longer than females. How we work Whether you are from a start-up or a big pharma company, we support anybody with a great idea with the potential to transform healthcare by making a positive health impact. Find our more here: EasternAHSN.org