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Digital self-management tools could help UK out of a musculoskeletal crisis

By Adam Jarvis, chief operating officer at Ascenti

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Adam Jarvis, chief operating officer at Ascenti, speaks about the benefits of digital self-management tools

The BBC’s ‘A Life of Pain’ programme recently shone a light on the impact that persistent pain and musculoskeletal (MSK) conditions are having on the 20.3 million people affected in the UK.

From lost independence, to derailed careers, to poor mental health, its prevalence is not only being felt in the UK, but worldwide too, with a recent analysis of Global Burden of Disease (GBD) data showing that approximately 1.71 billion people globally have MSK conditions.

Impact

In the UK, the impact of MSK issues on the NHS has been considerable, with 30 per cent of all GP consultations in England now for MSK conditions, and latest figures showing that more people are waiting for MSK treatments than any other form of care.

Worryingly, those patients who do get seen don’t always recover as quickly as they should either, as published studies show that an alarming 70 per cent of MSK patients do not engage in prescribed home exercise.

Whilst we know that the prevalence of musculoskeletal conditions such as osteoarthritis and fibromyalgia increases with age, younger people are also affected, with lower back pain now cited as the main reason for a premature exit out of the workforce.

Staying in the workplace, the number of working days lost to MSK injuries in 2019/20 was up a third on the previous year, with factors such as the rise in people working from their sofa or bed, increased sedentary activity levels and the physical effects of the pandemic being suggested as possible causes for the dramatic escalation.

Bridging the gap

Whilst the statistics paint a painful picture, new digital methods that empower patients with the knowledge, skills, and confidence to manage their own health more effectively are helping to bridge the gap when it comes to treating MSK issues.

Until recently, virtual physiotherapy services represented the minority of support offered by both the private and public physiotherapy sectors.

However, the Covid-19 pandemic created a sudden need for digital health services, with two thirds of patients (62 per cent) reporting increased use, according to a study by Imperial College London.

Another study found that when patients experience symptoms that aren’t concerning, the majority (60 per cent) would prefer to communicate with a clinician using digital tools.

It seems that, when it comes to managing their health, many people are increasingly turning to the speed and convenience offered by digital tools to access support.

A hybrid solution

One example of how digital self-management tools are changing the healthcare landscape is Ascenti Reach, a physio-led, self-management app that’s been four years in development and has now been used by 12,000 patients.

Reach is the first physio app to provide an end-to-end hybrid solution, including digital triage, personalised video-led exercise plans and 24/7 access to online clinician support, allowing patients to get advice and support at a time and place that suits them.

Ascenti Reach is a physio-led, self-management app

While other apps are about keeping people out of care, Reach identifies the most appropriate, safe, motivating, and convenient treatment pathway for the individual at that time, providing them with the tools they need to effectively manage their health.

It is a great way to empower people to have more control over how their care is delivered, which is very much in line with the NHS’ commitment to personalised care.

The approach also supports a more preventative healthcare perspective, allowing patients to access care more quickly, before their condition progresses into something more severe.

Effective and engaging

A pilot study of c.1,000 MSK patients that accessed support through Ascenti Reach found that it is clinically effective in reducing patients’ pain and that it significantly increases people’s engagement in prescribed exercise.

While we know that most patients don’t follow home exercise advice given to them in-person by their physiotherapist, this study showed that nearly half of users accessed Ascenti Reach 5+ times per week, while a further 30 per cent used it three to four times per week.

Not only that, but 53.5 per cent were still using it after eight weeks.

A range of benefits to this kind of self-management service were identified in the study, including the convenience of not having to leave the house or book time off work for an appointment, the reassurance of being able to quickly check things with a clinician and the empowerment that comes from being equipped to take an active role in your treatment, rather than simply attending appointments with the intention of ‘being treated’.

The fact that 40 per cent of messages sent to clinicians in the course of the study were sent outside of traditional working hours shows what an impact being able to seek support at a time that is convenient to the individual could make.

There were some challenges identified too of course, including the risk of digital exclusion, which is why it’s so important that patients are able to choose the treatment method that is right for them.

Not everyone can access digital tools and some people just feel a greater sense of trust when they see someone in-person.

The study concluded that physio-supported self-management tools like this should only be offered as part of a broader healthcare ecosystem that also supports in-person treatment, which is something that Ascenti offers too, through its 300 nationwide clinics.

Physio-supported self-management will never replace in-clinic treatment, however, used effectively, the evidence suggests it can improve the patient experience, increase engagement in prescribed exercise and deliver clinically meaningful outcomes.

It might also broaden the range of careers available in physiotherapy, attracting more clinicians into the workforce and ensuring that we are well-placed to support the management of MSK issues for a healthier population.

For more information on Ascenti Reach and the findings of the study, click here.

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