Transcript The M-PROM

The MSK-HQ
Developing a generic Musculoskeletal Patient Reported Outcome Measure
Policy & Public Affairs Team, Arthritis Research UK
e. [email protected]
07 July 2015
The MSK-HQ
The Context and Challenge
Musculoskeletal conditions have significant impact on those living
with them, on the health service and on wider society
•
There are over 200 different musculoskeletal conditions. They include:
- Long term conditions such as rheumatoid arthritis and osteoarthritis which are
painful, life-long and often fluctuate in severity
- Short term conditions such as sprained joints
•
Musculoskeletal conditions are the single biggest cause of disability in
the UK
•
In 2009/10 there were 21 million primary care consultations for MSK
conditions
•
In 2011/12 musculoskeletal treatments accounted for £5.06 billion in the
NHS, making it the 4th largest area of current programme spend
The MSK-HQ
What are PROMs?
• Patient reported outcome measures (PROMs) are a way
of recording how people rate their own health status
- Before and after surgery
- At regular intervals for people with long term conditions to track health
status over time
• PROMs provide patient level data to allow quality
improvement across health services
- Informing clinical care
• Above all, PROMs are person centred, and enable
people to self manage their own health
The MSK-HQ
Developing the ‘Arthritis Research UK
MusculoSkeletal Health Questionnaire’ (MSK-HQ)
• PROMs are of particular value in musculoskeletal conditions
where few biological markers are available to assess the effect
of disease on a person’s health
• PROMs are not yet consistently adopted in musculoskeletal
care partly due to the complexity of the field:
- The complexity of care pathways for musculoskeletal conditions
- The number of care settings used to treat people with musculoskeletal
conditions
• There is need for a measure which is of utility throughout the
patient pathway, proving joined up care
The MSK-HQ
Who is involved in the care of people with a
musculoskeletal condition?
The MSK-HQ
Community consensus meeting
A meeting was held in Birmingham, July 2012, with people with arthritis,
research teams, professional-representative organisations, patientrepresentative organisations, teams with experience of PROMs delivery and
Department of Health and NHS Information Centre
What the community wants - seven key themes emerged:
1. The MSK-HQ is feasible, welcome and worthwhile
2.
MSK-HQ and data must be meaningful to patients
3.
MSK-HQ should sit along EQ5D (± OEQ) with a multidimensional core
4.
Clearly define and test MSK-HQ audience
5.
Base MSK-HQ on existing work where possible
6.
Adopt condition-inclusive approach and test
7.
Work needed to understand PROMs use in LTCs
The MSK-HQ
A multi-dimensional tool: What modules may be
needed?
Pain
Mood
Fatigue
Self-efficacy
Dexterity
Mobility
The MSK-HQ
Future aims for a generic MSK-HQ
•
There is value in developing a generic MSK-HQ: Potential to enable
people across a number of musculoskeletal conditions to report their health
status.
- People can track their own health
- The instrument can be used across full range of health professionals
- This ensures no gaps in coverage
•
Inclusion of an MSK-HQ in strategic approaches such as the national
PROMs programme and national outcomes frameworks: Potential to
drive improvement in health services for people with musculoskeletal
conditions
- Providing benefits to commissioners
- Providing a longitudinal measurement throughout the pathway
•
Integration of an MSK-HQ into clinical practice: Potential to support
improvement in clinical practice, and self-management
- Enabling more effective monitoring of health status
- Standardised and simplified throughout NHS
- Providing a holistic view of the impact on a person’s health
Over time we would like to see inclusion of the MSK-HQ in
clinical practice, in the national PROMs programme and in
national outcomes frameworks
The MSK-HQ
Anticipated benefits of the MSK-HQ
In clinical practice and selfmanagement
In health service
improvement
•
Improving patient level and service
clinical outcomes
•
•
Providing patients and clinicians with
real time feedback
Benchmarking opportunities e.g.
comparison of clinical outcomes
across and between a range of
services
•
Supporting self-management
throughout the whole patient pathway
•
Identifying variation in care quality /
demonstrating QIPP adherence
•
Providing a single measure for use
across a range of musculoskeletal
conditions
•
An instrument to measure high
quality commissioning
•
Pathway evaluation / redesign
•
Providing reporting opportunity for
contextual data to commissioning
structures, including the NHS
England Commissioning Board
•
Producing patient data to inform
future research questions
•
Providing a measure of utility to a
range of healthcare professionals
•
Simplifying a complex field in which a
variety of outcomes measures are
used
The MSK-HQ
Where next?
Development of the MSK-HQ tool:
•
Arthritis Research UK launched an open research call in March 2013.
•
Following a peer-review process of all applications, the award was made in
August 2013 to a joint application between Keele University Primary Care
Sciences Research Centre, led by Dr Jonathan Hill, and Oxford
University’s Nuffield Orthopaedic Centre, led by Professor Ray
Fitzpatrick.
•
With the completion of phase one, phase 2 was initiated in June 2014, and
led by Oxford University’s Professor Andrew Price.
Other activity:
•
A Stakeholder Reference Group for the MSK-HQ has been established.
•
In December 2013, a group meeting was held to discuss research progress.
•
A Stakeholder meeting is planned for May 2015 where the initial findings
from phase 2 will be discussed and will outline thinking on next steps.
The MSK-HQ
Phase 1 & 2
• Phase 1:
The first phase is the development of a candidate MSK-HQ instrument,
including the input from patients, researches and health care
professionals. This phase was completed in Summer 2014.
• Phase 2:
The second phase is the longitudinal testing of this instrument in a range
of clinical pathways and settings, including general practice, community
physiotherapy, orthopaedics, rheumatology and a local health care
economy, to address its logistical aspects as well as the more scientific
aspects of its practical validity and interpretation. This phase is expected
to last around 12-18 months and is funded jointly by Arthritis Research
UK and NHS England.
For more information on the MSK-HQ, or to request a
PowerPoint version of the slides, please contact the Policy
and Public Affairs Team at the following email address:
Policy & Public Affairs
[email protected]
07 July 2015