Abstract
BackgroundPsoriatic arthritis (PsA) is a complex condition that requires high levels of self-management from those living with the condition. It is associated with many comorbidities, including depression, metabolic syndrome, and increased cardiovascular disease risk and can adversely affect quality of life. There is growing evidence that people living with psoriatic arthritis (PsA) are more likely to be overweight, consume alcohol above recommended levels, smoke, be affected by poor sleep, fatigue, anxiety, and take insufficient exercise for healthy living. These modifiable health behaviours further increase the already known risk of cardiovascular morbidity and mortality. These issues are not systematically addressed in routine clinical care due to low confidence in effective delivery and time constraints.ObjectivesTo co-develop evidence-based patient-focused learning materials to support healthy lifestyle changes for people living with PsA.MethodsThe development of the materials was overseen by a steering group of people living with PsA, psychologists, rheumatologists, and researchers. The COM-B model was used in the development of the materials, and they are designed around motivational interviewing principles. Firstly, a systematic literature review was performed to establish the evidence for the current burden and potential interventions aimed at these issues in PsA. These included diet, weight, alcohol, smoking, exercise, anxiety, depression, and stress. An initial focus group of people living with PsA was used to identify priority behaviours and ideas for content.The steering group developed draft materials, and we partnered with a design agency to create engaging materials. They developed a website and downloadable postcards. A second focus made up of people living with PsA was held for people to give their views on the draft content for the materials and initial design ideas. A third focus group was held with people living with PsA and a fourth with clinicians to refine the design materials and ensure they were accessible, interesting, and helpful to initiate and maintain change. A final evaluation survey was performed to review the draft website before launching the final materials. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) approved the final materials.ResultsFollowing the steering and focus groups’ input, 15 candidate topics were prioritised (Table 1). A website and downloadable postcards summarising each of the topics were developed by the design team and refined following feedback from the patient focus groups. An example of the postcard for ‘keeping active’ can be found in Figure 1. The resources are free to use and can be accessed at https://www.informatree.org.Table 1.Topics1Pain2Fatigue3Healthcare appointments4Tobacco5Different treatments6Alcohol7Work8Social support9Food and weight10Sleep11Keeping active12Mood13Intimacy14Travel15Using treatmentsFigure 1.During the development of the website and downloadable postcards, particular attention was paid to making the material as accessible and as friendly as possible for patients.ConclusionThis project created patient-focused information to support behaviour change in clinical practice. It addresses common concerns of people living with PsA about how they may optimise their health by providing practical and brief interventions to challenge and support them to make personal changes. Future research is needed to test the impact of the resource.AcknowledgementsThis research project was funded by a Medical Education Grant from Pfizer. SK was funded by Cancer Research UK (grant C49297/A27294).Disclosure of InterestsLouise Hailey: None declared, Christine Bundy Consultant of: Over the last 3 years, I have received funds for consultancy from the following pharmaceutical companies: Abbvie, Almirall, Amgen (was Celgene), Beiersdorf, Janssen, Novartis, Pfizer, UCB., Grant/research support from: Over the last 3 years, I have received funds for research and honoraria from the following pharmaceutical companies: Abbvie, Almirall, Amgen (was Celgene), Beiersdorf, Janssen, Novartis, Pfizer, UCB., Laura Howells: None declared, Shona Kirtley: None declared, Sam Martin: None declared, Denis O’Sullivan: None declared, Ingrid Steinkoenig: None declared, Melissa Stepney: None declared, Laura Coates Speakers bureau: LCC has been paid as a speaker for AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Medac, Novartis, Pfizer and UCB., Consultant of: LCC has worked as a paid consultant for AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Moonlake, Novartis, Pfizer and UCB., Grant/research support from: LCC has received grants/research support from AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer and UCB.
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