The Idea

Patient information leaflets have been common practice in musculoskeletal (MSK) physiotherapy departments for 20 years (Lubrano 1998, Bragg 1999).

Traditionally, patient information leaflets have been produced in paper format and given to patients directly upon assessment by a clinician (Ketola et al 2015) and some studies have suggested usability issues with text based leaflets (Hammar et al 2016, Medicines Management Collection 2010).

Despite advances in technology, digitised versions of these leaflets remain scarce in practice. Research shows that use of digitised patient information can improve clinical outcomes (Hammar et al 2016), allowing patients with a varying degree of literacy skills to access previously inaccessible material and care (Houts et al 2006). It has been suggested that a combination of both digitised and paper leaflets could further enhance patient satisfaction and clinical outcomes through self-guided management (Hammar et al 2016, Cameron et al 2018).

In a time where patients are becoming more actively informed about their healthcare and consuming more online information, it stands to reason that providing NHS physiotherapy patients with best evidence–based care at the initial point of need will help improve overall patient outcomes.

The Name

The team name we have chosen is; SPIIKE70 – Specific Interactive Information for Musculoskeletal Conditions, the ‘70’ is in recognition of the NHS 70^th Anniversary this year.

The Aim

We propose to create condition specific patient information leaflets; ensuring that each leaflet has an easily accessible digital and paper copy and is fully integrated with the software packages and website used at Ashford and St. Peter’s Hospitals NHS Foundation Trust.

The Plan

•           We believe involving as many stakeholders as possible will help enhance the project’s scope and success. Initially we plan to hold a focus group comprising of a patient representative, General Practioner (GP), Extended Scope Practitioner (ESP), graphic designer and physiotherapists.
•         We will use surveys in order to gain an in-depth understanding of what information is already available. This will enable us to canvas the opinion of service users, GPs, physiotherapy assistants and ESPs. All leaflets will be ratified not only by the Trust’s panel but also by a prospective panel of rehabilitation experts in this particular field.
• We will then create condition specific leaflets, based on the latest evidence, for patients to access in both paper and electronic format. This electronic format will be that of an interactive pdf file created using Adobe InDesign in collaboration with the designer. Leaflets will be created in line with trust standards and ratified in accordance with trust policy. A further policy will be drawn up for on-going work to update these leaflets, again in-line with trust directives.
• Exercise videos housed within the interactive pdf will be created and used in collaboration with ‘Physiotec’ – a rehabilitation software company, we have a close working relationship with.
• All leaflets created will be uploaded onto the trust website and Surrey iMSK website for patient access.
• Leaflets will be housed within a patient portal allowing any patient access to the information and graded exercise programmes at their point of need.
•       We intend to advertise the resource internally and at local leisure centres and gyms to maximise access.

Who Benefits From This?

Patients – patients are actively consuming more online information and this is not always evidence based and can lead to confusion and poor outcomes. Providing evidence-based guidance and interactive exercise programmes at a patient’s initial point of need will reduce the risk of chronicity and promote self-management.

Physiotherapists – Due to the modern advancement in physiotherapy treatment, physiotherapists now have a greater understanding of wider issues and how this can affect a patient’s care. By having ready-made resources, such as these leaflets, physiotherapists will be able to work more time efficiently allowing them to work collaboratively with patients to overcome social and psychological barriers to self-management. 

Primary Care GPs – the electronic leaflets will help increase a GP’s knowledge and confidence with MSK conditions allowing them to best advise their patients on treatment. Use of these leaflets may reduce GP follow up rates and referrals into secondary care.

Community Leisure Centres – by incorporating a biopsychosocial approach, the leaflets will promote the need to follow a balanced healthy lifestyle, something that local gyms and leisure centres can provide support with. Patients attending these centres with greater knowledge of their current condition and a graded exercise programme, will be better placed to engage with fitness instructors and personal trainers.

How Can This Help The Q Community?

The creation of electronic physiotherapy leaflets could act as a template for other organisations and NHS trusts to develop their digital information in order to aid patient centred care.

We will document our progress along the way through the medium of blogging in order for the Q community to stay up to date.