SMILE-RA-SELF-MANAGEMENT INDIVIDUALISED LEARNING ENVIRONMENT in RHEUMATOID ARTHRITIS

ABSTRACT

Background: An important but insufficient aspect of care in people with infam-matory arthritis (IA) is empowering them to acquire good understanding of their disease and build ability to deal effectively with the practical, physical and psychological impacts of it. This extends beyond drug therapy and emphasises the ability to self-manage, with the right support, as an essential component of care. Good self-efficacy and coping skills reduce health and fnancial burden to the individual as well as the health service, beneftting society overall. Provision of excellent supported self-management education is at the heart of what NRAS does and it was due to the difficulty of getting Commissioners to fund our face-to-face group self-management that led to our building an e-learning programme to expand on and replace our 6-week programme. Objectives: To co-create an intuitive, easy to use, modular e-learning programme, free for all and which health professionals (HCPs) could refer their patients to. This makes supported self-management and evidence-based education accessible to all, wherever they live. SMILE enables HCPs to meet both NICE guideline and quality standards in RA against which rheumatology units in England and Wales are currently audited, as well as EULAR Recommendations for self-management strategies in infammatory arthritis. Methods: In 2019 with initial funding in place, we worked with our provider to help us realise our goal of developing a state-of-the art e-learning experience in a modular format for people with RA. The programme had to be 1) simple to use;2) interactive;3) innovative and engaging;4) able to measure impact through achievement of learning objectives and use of a validated patient reported outcome measure. The programme also had to be integrable with our Salesforce database enabling us to collect data and target resources to individuals, driven by identifed need. Results: Delayed by COVID, we launched with 4 modules on 17/09/2021. The 4 modules comprise Foundation Module covering the importance of self-management which has the RA Impact of Disease PROM embedded;Newly Diagnosed;Meet the Team and Managing Pain and Flares. A ffth module on Medicines in RA will be launched 1st quarter 2022 and 4 further modules will be uploaded in 2022. To date (26/01/22), 760 people have registered, of which 313 have completed a baseline RAID and this reveals that <50% are achieving minimal acceptable state of 3 or less. Over 78% of registrants are not NRAS members, and 634 modules have been completed. Early indications are that almost all are achieving learning objectives. More data will be available by June 2022. Conclusion: Early indications demonstrate that people are successfully engaging with the programme and we have marketing activity lined up to raise further awareness of the value of SMILE with both potential users and rheumatology teams in 2022. Massive workforce issues together with signifcant backlogs of existing patients caused by the pandemic, have restricted the ability of Teams to provide education and self-management support for their patients. SMILE offers high quality, evidence-based learning opportunities for their patients and has been co-created with health professionals and people with RA at every step. With remote consultations here to stay, the importance of patients having access to evidence based online learning which they can tailor to their specifc needs and improve their self-efficacy is even more critical.