Abstract

Abstract Background Despite recommendations by NICE in the management of axial spondyloarthritis (AS), adherence to exercise and self-management education is reported to be variable. The Axial Spondyloarthritis Know-How (ASK) self-management programme is a single attendance exercise and education workshop supported by a self-management digital toolkit. The ASK digital toolkit consists of a short educational film, a self-assessment tool and interactive self-management handbook to support health behaviour change following attendance. The feasibility of delivering a digital self-management programme for adults with AS was explored prior to implementation. Methods The development of the ASK digital toolkit involved service-users and charity partners from the National Ankylosing Spondylitis Society (NASS) with user-testing and feedback contributing to the reiterative design of the digital resource. Service-users were also involved in the co-production of the ASK film. The feasibility of delivering the ASK self-management digital toolkit via a link in an automated pre-appointment SMS was evaluated using a patient questionnaire. Results 23 patients (12 male; 11 female) completed the feasibility questionnaire between February and April 2019. The acceptability of the ASK digital toolkit was rated 9.6/10. The trustworthiness and safety of data were rated 9.4/10 and 8.6/10 respectively. The helpfulness of receiving the ASK self-management handbook prior to attendance was rated 8.2/10. The overall helpfulness of the ASK digital tool in supporting self-management was rated 9.1/10. The acceptability of receiving the self-assessment tool at 3-, 6- and 12-month follow-ups to support adherence to self-management was rated 9.5/10. 67 patients completed the ASK self-assessment tool prior to attendance. 10.5% (7/67) reported not being sure of their diagnosis on attendance. 83.5% (56/67) viewed the ASK film prior to attendance with 81.5% (44/54) rating it ≥ 7/10 in managing expectations of the workshop. 62.7% downloaded the ASK digital self-management handbook with 62.7% (32/42) rating the ASK handbook ≥7/10 in helping to prepare to attend ASK. 23.1% (15/65) reported performing ≤ 30 minutes of physical activity/week. 11.3% (7/62) were smokers. 12 Patients completed the 3-month follow-up self-assessment tool (June-August 2019). 100% understood their diagnosis. 75% (9/12) were using the ASK self-management handbook on a range of devices with 25% using the ASK handbook weekly and 75% when they had a new problem e.g flare.100% were happy to receive the ASK self-assessment tool in a further 3 months for support. 9.09% (1/11) report performing ≤ 30 minutes of physical activity/week. 100% were non-smokers. Conclusion A digital-first approach to the delivery of the ASK self-management programme was acceptable and rated highly for helpfulness in preparing patients for a journey of self-management. Delivery of the ASK toolkit appears to be feasible using digital technology and has the potential in supporting adherence to self-management for patients with AS. Disclosures M.J. Martin Honoraria; Novartis, Abbvie. Grants/research support; National Ankylosing Spondylitis Society.

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