ESCAPE-pain resources to support people with chronic joint pain during Covid- 19

ESCAPE-pain: supporting people with chronic joint pain during Covid-19

The ESCAPE-pain programme is usually delivered as a face-to-face class to groups of about 10 people in Physiotherapy Outpatient Departments, leisure or community sites in over 290 venues across the UK. However, the Covid-19 epidemic has meant these venues have been forced to suspend face-to-face classes.

This has encouraged the team to find innovative new ways of supporting people with knee and hip pain who are now confined to their homes. Which includes, a new public ESCAPE-pain Facebook page has been launched where participants can visit to share stories, ask for guidance, and seek and provide peer support.

In addition the ESCAPE-pain smartphone app and online is now free-to-use and the hope is that is through the programme people can remain active and manage their joint pain during this time through the following resources:

  1. ESCAPE-pain Online can be viewed on a range of mobile devices but is best viewed on a computer;
  2. The ESCAPE-pain app is available on Android devices from the Google play store.

Note – Both tools require users to register and then follow a six-week programme, with two sessions each week, using exercise and educational videos and measuring the user’s ability at the start and end so they can see their progress.

To support home exercise further, the exercise and educational videos from the app are now also freely available on the ESCAPE-pain website so that people don’t need to create an account to view them, or for people who don’t wish to follow a structured programme and just want a reminder of how to do an exercise.

ESCAPE-pain has changed my life a great deal actually and I am just over the moon about it.
  1. The exercise videos are designed so that the exercises can be done in a home setting using everyday household items like chairs or steps. They are simple and easy to follow with audio instructions. Just click on each video to get started. You don’t have to do them all, choose a few you find easy, then add or drop exercises as you want. If you want to view the exercise in full screen mode, click on the bottom right hand corner of each video where you can see a small square. Why not also look at our top tips (on the same page) of how to exercise safely in your home?
  2. The educational videos can be viewed at any time to learn more about your joint pain. They give simple advice and information to help people learn about how to better manage their condition. Just click on each video to get started. If you want to view the video in full screen mode, click on the bottom right hand corner of each video where you can see a small square.
  3. It is recommended that people read through the ESCAPE-pain support tools guidance which contains top tips for getting the best out of the digital tools. In addition, some ESCAPE-pain sites have started delivering virtual ESCAPE-pain classes. So, if you’re one of those people who would benefit from the interaction and would find it more motivating then follow the @escape_pain Twitter account to find out where and when these are happening.

For more information, and support contact hello@escape-pain.org.

Reduced pain and improvement in physical function are only some of the positive results of the programme. Watch the latest participant video below.

ESCAPE-pain programme reaches 200 sites

ESCAPE-pain programme reaches 200 UK sites

This month the ESCAPE-pain programme launched its 200th site in the UK. It now operates in every region in England, with sites also operating in Wales and Northern Ireland. Over 13,000 people have attended the programme to date.

Originally rolled out by physiotherapists in hospitals, ESCAPE-pain is now also offered to people in leisure centres and gyms, church halls and community centres.

ESCAPE-pain is an evidence-based rehabilitation programme for people with chronic knee and/or hip pain, also known as osteoarthritis. It integrates exercise, education, and self-management strategies to help people live more active lives and manage their pain better. It offers an opportunity to reduce the number of GP consultations for knee and hip pain and reduces prescriptions of painkillers for these people.

The programme was developed by Professor Mike Hurley and is hosted by the Health Innovation Network. Nationwide scale-up is currently being supported by NHS England and Versus Arthritis.

ESCAPE-pain has been shown to:

  • Reduce pain, improve physical function and mental wellbeing.
  • Sustain benefits for up to two and a half years after completing the programme.
  • Reduce healthcare utilisation (medication, GP appointments, secondary care) equating to an estimated £1.5 million total savings in health and social care for every 1,000 participants who undertake ESCAPE-pain.

You can find your nearest ESCAPE-pain programme here.

How to find out more and hear personal real-life experiences here.

To find out more about ESCAPE-pain visit their website or follow them on Twitter @escape_pain

 

Meet the Innovator

Meet the Innovator

In our latest edition, we spoke to Mike Hurley, creator of ESCAPE-pain – a rehabilitation programme for people with chronic joint pain. Mike is currently a Professor of Rehabilitation Sciences at St George’s University of London & Kingston University as well as Clinical Director for the Musculoskeletal theme at Health Innovation Network.

Tell us about your innovation in a sentence

ESCAPE-pain “does exactly what is says on the tin”, it’s a rehabilitation programme for older people with chronic knee or hip pain (often called osteoarthritis) that helps participants understand why they have pain, what they can do to help themselves cope with it, and guides them through an exercise programme that helps them realise the benefits that can be attained from being more physically active.

What was the ‘lightbulb’ moment?

Not sure it was a lightbulb moment, it was more like one of the low energy lights slowly coming on! But there were two turning points that have led to ESCAPE-pain.

The first was realising the impact of pain on people’s everyday physical and psychosocial function was as important to them as the sensation of pain itself, and that addressing these impacts is as important as minimising pain.

The second was realising the importance muscle plays in causing joint pain and joint damage. We used to think joint pain was caused by damage to joints that resulted in pain, this stopped people doing their regular activities, which caused muscle weakness and makes the joint susceptible to further damage. However, we highlighted muscles are very important for protecting our joints from abnormal movement and suggested impaired muscle function that occurs as we get older may initiate joint damage. Thus, muscle is a cause rather than simply a consequence of joint damage. If that’s true then maintaining well-conditioned muscles through exercise-based rehabilitation programmes, we might prevent or reduce joint pain and damage, and improve people’s quality of life.

Coupling the first light bulb moment – addressing the psychosocial impact of pain – with the second light bulb moment – experience and understanding of the value of exercise – gives us ESCAPE-pain.

What three bits of advice would you give budding innovators?

  1. Prove your innovation works – if people aren’t convinced it is useful to them why would they use it?
  2. Surround yourself with a team of clever, hardworking people who believe in you and the innovation.
  3. Keep your eyes on the prize – wide implementation – and be prepared for lots of ups and downs and hard work convincing the multitude of non-believers that your innovation works.

What’s been your toughest obstacle?

Some of the conversations we had with commissioners would have been laughable if they weren’t so depressing. Financial pressures mean people delivering the programme continually want to reduce the number of sessions, but we know doing that reduces its effectiveness. And even though commissioners were often convinced about the need for the programme and wanted to do the right thing, the requirement to focus on short term benefits meant that anything taking more than a year to show benefits, whether health or cost, was of little interest. Many felt unable to invest in services where the benefits are felt by other parts of the health system, for example taking the pressure off primary care. Often commissioners could hear the madness of what they were saying even as they articulated it, but that didn’t change anything. It was tough and these issues really do slow the spread of innovation.

What’s been your innovator journey highlight?

Getting the unwavering backing of the HIN. In late 2012, I was about to give up on getting ESCAPE-pain adopted clinically, because there were no channels for innovative healthcare interventions to spread across the NHS and beyond. Then I answered an email enquiring about local MSK research in south London from its newly founded Academic Health Science Network, met with the Managing Director and frankly my professional life took a new, exciting and very fulfilling turn for the better.

Best part of your job now?

There are two:

Working with the MSK team is terrific and fun. They work so hard to make it everything work. It’s a privilege to work with such a lovely group of people.

The second great thing is the kick the whole team gets from the positive feedback we get from ESCAPE-pain participants. It never ceases to make me feel very humble and honoured to be able to help people.

If you were in charge of the NHS and care system, what’s the one thing you’d do to speed up health innovation?

I’d start “NICE Innovations”, a body that would screen potential (digital, models of care and service) innovations, pick the most promising, work with innovators and the health systems to find out what works (or not), why (not), and then actively promote and incentivise the health and social care systems to adopt or adapt effective innovations. Its kind of happening at the moment but feels fragmented, so it needs to be brought together to make it more effectual and “given teeth”.

A typical day for you would include..

The great thing about my work is that there is no typical day. I usually wake about six, make a cup of tea and listen to the news on the radio before heading into the new day. That could involve writing papers, grants, presenting at conferences, attending meetings at the HIN or St George’s, lecturing, mentoring students or clinicians, figuring out how to get our MSK work seen and adopted.

Find out more about ESCAPE-pain by visiting the website at www.escape-pain.org or following them on twitter @escape-pain

Contact us

W: chc2dst.com and ieg4.com (main company website).

T: @IEG4

Community health trainers are tackling high cost of chronic joint pain in innovative new programme

Chris-smith

New study shows community health trainers are tackling high cost of chronic joint pain

New study shows NICE approved new chronic joint pain intervention could be rolled out across the country through community health trainers.

An intervention that relieves chronic joint pain, called Joint Pain Advisor, has been successfully piloted with community health trainers in south London in a project that reduces pressure on GPs and has the potential to improve the lives of millions of people living in pain.

Musculoskeletal (MSK) pain, which includes chronic knee, hip and back pain, has a major impact on individuals and society. It is the second most common reason for GP visits, accounts for around 25% of all GP consultations and is estimated that 9.3 million working days are lost in the UK to MSK problems.

The Joint Pain Advisor model of care is a safe and cost effective alternative to GP consultations. Involving a series of face-to-face consultations, advisors work collaboratively with people with hip and/or knee osteoarthritis and/or back pain, focusing on supporting self-management. This model has been previously delivered by physiotherapists as Advisors but this new, small-scale study trained health trainers to deliver the advice in the community.

The study has shown that using community health trainers to deliver the Joint Pain Advisor model is effective. Many participants of the study said that their pain was dramatically reduced and movement had returned. They reported taking fewer pain-killers as well as increased mobility and weight loss.

The finding is significant because extending the model to community health trainers could result in much faster growth and mean that many more people can benefit from the service. There are around 3,000 community health trainers at present, who currently provide lifestyle advice on issues such as smoking cessation, weight management and healthy eating. Extending the programme to these trainers could mean that thousands more people are able to live in less pain.

Health Innovation Network Clinical Director Professor Mike Hurley said:
“The Joint Pain Advisor approach allows many more people with joint pain to benefit from NICE advice. Our service enables patients to help themselves live better lives – in less pain, able to do more, with a better quality of life.
This new study is small scale but extremely promising. Not only do we know that the Joint Pain Advisor service works to empower people to manage their pain, but through using the thousands of community health trainers up and down the country we can spread this innovation rapidly and help many more people.

With GPs under so much pressure and the countless working days lost to chronic joint pain, our programme could provide both economic and health and care benefits to the NHS.”

To date over 500 patients have used the service with physiotherapists in a previous pilot in Lewisham, south London, and they reported less pain, better function and higher activity levels. A high satisfaction rate was achieved which included reduced BMI, body weight and waist circumference and has led to fewer GP consultations, investigations and onward referrals. For every £1 spent on the programme there is a saving to the health and social care system of up to £4, according a Social Return on Investment (SROI) analysis.
The programme consists of up to four 30-minute face-to-face consultations between the advisors and people with hip or knee osteoarthritis (OA) or back pain. Patients attend an assessment where they discuss their lifestyle, challenges and personal goals and then jointly develop a personalised care plan that gives tailored advice and support based on National Institute for Health and Care Excellence (NICE) guidelines for the management of OA. They are then invited to attend reviews after three weeks, six weeks and six months to access further tailored support and advice.

Patients involved in the pilot said:
“Before I came, I used to have a lot of pain. Now I can do more walking. It’s helped me.”
“The pains eased, because I’ve strengthened my knees.”
“I’ve stopped taking painkillers because my hip has stopped hurting.”

In the latest study, 10 health trainers were trained as Joint Pain Advisors (JPAs) by the Health Innovation Network and offered the service across six community sites across Greenwich. It involved 85 participants between March 2017 and January this year.

Joint Pain Advisors are currently available in Shropshire and Merton, with plans for Croydon, Bromley and Cornwall to launch Summer 2018.

Download full report Joint Pain Advisor – Greenwich