Background It has been shown that arthritis management in primary care does not always meet guidelines (Goodwin 2010) and that insufficient knowledge of Rheumatoid Arthritis (RA) and Osteoarthritis (OA) can lead to a lack of ability to educate and inform patients. To ensure people with arthritis receive the care they need and consistent self-management and life style messages it is important that all health professionals (HPs) they may have contact with are familiar with arthritis, its impact, diagnosis and management. There is very little evidence on the education community based HPs need in order to fulfil these requirements (Fletcher 2012, Lillie 2012, Mann 2012).
Objectives To identify what education community based nurses and allied health professionals (AHPs) need to enable them to appropriately assess, care for and manage arthritis.
Methods The study used a Delphi survey technique with an Expert Panel of 43 rheumatology specialists and expert patients was established to identify the competencies needed by community based nurses and AHPs (occupational therapists, physiotherapists, podiatrists and community pharmacists) to enable them to care for people with arthritis. Focus groups were held with a total of 25 women and men with inflammatory arthritis (IA) and OA and with 26 community based nurses and AHPs to elicit their views on what nurses and AHPs need to know to enable them to appropriately and effectively care for people with arthritis.
Results Frameworks for the core competencies in arthritis care for community based HPs and for profession specific training were developed. The key goals identified were to increase HPs understanding of arthritis, and its impact on patients' lives and to increase their ability to help patients self-manage their condition and access all the means of support available to them. Competencies include a basic understanding of the pathology underlying inflammatory and non-inflammatory arthritis, the ability to distinguish between the two and to recognise early warning signs with emphasis on OA, RA, gout and septic arthritis. Essential competencies included the ability to engage in shared decision making, goal setting, signposting, to provide patients with education and information and to make appropriate referrals.
Conclusions Health professionals (HPs) working in the community commonly encounter arthritis as a presenting problem or as co-morbidity. Care quality to people with IA and OA is currently highly variable and sub-optimal and could be significantly improved (Goodwin et al 2010). This study identifies the core competencies that all community based nurses and AHPs should have in relation to OA and IA.
Fletcher MJ, Oliver S, Cook A et al.2012 An investigation into practice nurses' need for further education in musculoskeletal care. Practice Nursing 23(1):40–46.
Goodwin N, Curry N, Naylor C et al. 2010. Managing People with Long Term Conditions. Kings Fund London www.kingsfund.org.uk (accessed 14/04/2013).
Lillie K, Adams J. 2012. The educational needs of nurses and AHPs caring for people with arthritis. Musculoskelet. Care DOI: 10.1002/msc.1035.
Mann C. 2012. Recognising and meeting the needs of people with osteoarthritis. Primary Health Care. 22(7):32–39.
Acknowledgement Thank you to all contributors. Funded by Arthritis Research UK
Disclosure of Interest None declared