Flare management in rheumatology: Advice line conversations

So I think that's great that you've covered that, um, and that people are aware that it's not, you know, our go-to.

There's lots of steps, as Jay's taken us through, um, brilliantly, that, you know, even before we get to this stage because actually giving that is, is a, is a big deal, isn't it? Giving the steroid therapy.

Absolutely, and I think it's sometimes important, um, to reinforce that with people because sometimes if people have had lots of steroid over the years, uh, they can forget what the, what the implications of that are.

So i- it's sometimes important even in people who are really experienced, um, with their arthritis, to be able to walk them through what the safety concerns are and why we're not just going straight away to offering steroids.

They-

And again-

... obviously have a place

... absolutely.

Absolutely, and I think, you know, just trying to get the, the, that inflammatory picture and, and think about actually is this what's needed, or actually is there something else going on? Um, and we know, you know, patients, as Elsa took us through brilliantly earlier, can be experiencing a flare for lots of different reasons.

Um, so it may not be the medicine that we need to sort of go in and, and do anything about.

It may be some of these other strategies that we, we've talked about.

So no, thank you so much for all of that, um, useful information.

And I think just listening to all three of you, um, uh, talk about sort of flaring and how patients can be affected, we- we've, you know, heard that it can affect mood.

Uh, Jane's talked about, uh, mental health, um, today, um, the impact on the patient and, you know, patients not being able to sleep, do their activities of daily living.

Um, and, and it is really hard for people that are, are in that position of being in a flare, as Elsa's taken us through.

So it is really important that we have services available for these patients, and they're able to get through to their, um, healthcare teams and seek help, um, when they have run out of steam and, and all their coping, uh, mechanisms that they've tried are not working.

So that is really important that we run, um, you know, really good, um, advice lines for patients to be able to access us, um, when, uh, they need us.

But coming back to you, Elsa, I, I know that, um, uh, there was an abstract at BSR this year, um, about some of the work that NRAS have been doing.

Um, and you've been developing a, a, a module, I believe, around managing, um, flares and pain, and I wondered if you might be able to walk us through a little bit of that.

Sure.

Um, so we have an e-learning program called Smile RA, which comprises currently eight modules, um, including one on managing pain and flares, which we co-produced, um, with the team from the Haywood and Keele, including Sam, of course, um, Ian, Scott, and Sarah Ryan, um, and the wider team.

And we wanted to evaluate the impact, um, of actually doing the module and what this impact had on people's ability to, um, know about managing their flares and having the confidence to manage their flares, uh, and their pain.

So we did a survey of people in early 2024 who had done the module, and, um, participants were asked how knowledgeable and confident they were at managing pain and flares before participating in the module and then again after they'd completed the module.

Over 600 people took part in the survey, and what we were able to show was a statistically significant improvement in people's knowledge and confidence to manage their pain and flares after completing the module.

Uh, for example, on the knowledge scale, uh, before the module, only 5% of people, um, said that they felt very knowledgeable about managing pain and flares.