i077 Self-management for osteoarthritis: where have we ESCAPEd to?

Abstract

Chronic knee and hip pain is a major cause of impaired mobility, physical and mental function and wellbeing. There is very strong evidence that informing people about their condition and how it can be manged, and controlled exercise/physical activity reduces joint pain and improves physical and mental health and wellbeing. Enabling Selfmanagement and Coping with Arthritis Pain through Exercise, ESCAPE-pain, (www.escape-pain.org) is a rehabilitation programme that integrates information and advice with a challenging, individualised, progressive exercise regimen.Evidence from clinical trials show ESCAPE-pain can reduce pain, improve mobility and physical and mental wellbeing for up to 21/2 years. Participation alters participant's health beliefs and behaviours (increasing physical activity), as they come to appreciate how increasing physical activity is a selfmanagement strategy they can use to reduce and control their symptoms and alter the course of the condition. To encourage adoption of the programme we worked closely with clinical departments to set up and run ESCAPE-pain, and then sustain the programme. We created support materials, processes, toolkits etc. By the start of 2018 it was being delivered in>50 clinical departments across the UK. Unfortunately, constraints within the NHS severely limits the number of people who have access to the programme. Therefore we have also looked at alternatives ways of delivering the programme. This presentation will describe: the processes, barriers and facilitators to implementation that we encountered; how these were surmounted, where possible and worked with/around where it wasn't; and our plans for large scale roll-out, evolution and enhancements to ESCAPE-pain.