SYMPHONI
Research type
Research Study
Full title
A SYstems approach to promoting Mental and Physical Health in people with lONg-term conditIons.
IRAS ID
304469
Contact name
Samantha Hider
Contact email
Sponsor organisation
Keele University
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary - Multi-morbidity is the co-occurrence of two or more long term conditions. People with long-term conditions such as rheumatoid arthritis (RA) and other inflammatory conditions are at high risk of multi-morbidity because they are more likely to develop other conditions such as heart disease and anxiety/depression. These conditions are more common and more severe but often less well managed than in the general population.
Lay Summary - People with inflammatory rheumatological conditions (IRC) for example rheumatoid arthritis are at an increased risk of having other long-term conditions like heart disease and anxiety and depression. Current reviews often focus on a single condition which patients describe as feeling like a ‘tickbox exercise’ with little room to discuss other issues such as the risk of developing other conditions.
SYMPHONI (A Systems approach to promoting Mental and Physical Health in people with long-term conditions) aimed to explore patient and clinician views on how healthcare reviews for people with IRCs.
We did individual interviews with Fifteen people with IRCs and and 3 focus groups with clinicians. We found there was duplication (so some people were offered multiple reviews) but some did not recall having any reviews. . People had different attitudes to wanting to know about risk of other conditions. People valued face-to-face reviews and felt a physical examination was important. Patients and clinicians felt that preparation before a review could help both parties understand what the review was for and support a person-centred discussion. The results were presented in our Community of Practice meetings, presented at Royal College of GPs conference and published in British Journal of General Practice Open.
Has the registry been updated to include summary results?: No
If yes - please enter the URL to summary results:
If no – why not?: N/A
Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Yes
If yes, describe or provide URLs to disseminated materials: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fbjgpopen.org%252Fcontent%252Fearly%252F2024%252F07%252F23%252FBJGPO.2024.0011%2FNBTI%2Flvq2AQ%2FAQ%2Fa1ec8cf7-560d-45d5-9a52-e9c70bbd6c85%2F1%2F4_E3OwAv9q&data=05%7C02%7Cbrightonandsussex.rec%40hra.nhs.uk%7C7143979a537f4a96073b08dcafb4cd49%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638578438276515226%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=CKynzXHcnKhjQ0FK0Enua6sQQeNXAPcCpXCIV0yx9fw%3D&reserved=0
If pending, date when dissemination is expected:
If no, explain why you didn't follow it:
Have participants been informed of the results of the study?: Pending
If yes, describe and/or provide URLs to materials shared and how they were shared:
If pending, date when feedback is expected: 16/08/2024
If no, explain why they haven't:
Have you enabled sharing of study data with others?: Yes
If yes, describe or provide URLs to how it has been shared: Data will be accessible via journal submission. Any interested groups and communities can contact corresponding author for more information.
If no, explain why sharing hasn't been enabled:
Have you enabled sharing of tissue samples and associated data with others?: No
If yes, describe or provide a URL:
If no, explain why: N/AIt can be challenging for people with arthritis to engage with recommended healthy lifestyle behaviours such as staying physically active or staying a healthy weight. We know that nurse led reviews can help and developed a face-to-face nurse led review (the INCLUDE review) which addressed heart disease risk, bone health and mood. This was feasible to deliver and led to changes in management. People having the review highlighted the value of dealing with more than one problem in a single consultation.
The COVID-19 pandemic has led to more remote consultations but how this fits with addressing lifestyle factors such as physical activity and weight isn’t clear. This study aims to explore patient and practitioner views regarding review consultations to address lifestyle risk factors for people at high risk of future multi-morbidity, considering peoples views on what the review should include and and how it is delivered.
Lay summary of study results: People with inflammatory rheumatological conditions (IRC) for example rheumatoid arthritis are at an increased risk of having other long-term conditions. Current reviews often focus on a single condition which patients describe as feeling like a ‘tickbox exercise’ with little room to discuss wider context including risk of developing other conditions.SYMPHONI (A Systems approach to promoting Mental and Physical Health in people with long-term conditions) aimed to explore patient and healthcare practitioner (HCP) perspectives on whether a healthcare review aimed at risk would be acceptable for people with IRCs and what this might look like.
Fifteen people with IRCs were interviewed and 3 focus groups with HCPs were conducted. This study found that there is duplication with some people being offered multiple reviews and other people being offered none which worsens health inequalities. People with IRCs at time had difficulty conceptualising reviews that discuss their future risk of conditions and may not include a face to face physical examination. And showed variable attitudes to wanting to know information about risk. People suggested that preparation before the healthcare review could help align patient and HCP agendas as part of a flexible and person-centred discussion.
Any review introduced for people with IRCs must move beyond a “tick box” exercise. To gain maximum value from a review, preparation from both patient and HCP may be required alongside a person-centred approach whilst ensuring they are targeted at people most likely to benefit.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
22/PR/0162
Date of REC Opinion
21 Mar 2022
REC opinion
Further Information Favourable Opinion