O32 Impact evaluation of an online training on the Strengthening And Stretching for Rheumatoid Arthritis of the Hand (SARAH) programme recommended in the NICE guidelines for rheumatoid arthritis

Abstract

Background: The SARAH programme is a progressive 12-week hand and arm exercise programme for people with hand dysfunction due to rheumatoid arthritis (RA) which was found to be clinically and costeffective in a large clinical trial. The SARAH programme is recommended in the NICE guidelines for the management of RA. To aid translation of this evidence-based programme into NHS practice, we developed an online training (iSARAH) for physiotherapists and occupational therapists by involving stakeholders in its design, development, and usability testing. iSARAH is available at https:// isarah.octru.ox.ac.uk providing unlimited free access to NHS therapists since April 2017. As part of our ongoing NHS implementation evaluation projects, we are conducting an impact evaluation of iSARAH in 250 therapists who complete iSARAH training and a service evaluation in 300 people with RA. The purpose of this study is to evaluate the impact of iSARAH on perceived competence, implementation intention, learner satisfaction, and perceived barriers for implementing SARAH in clinical practice in therapists who complete iSARAH. Method(s): Therapists are asked to complete a short online feedback questionnaire upon completion of iSARAH. Perceived competence, intention to deliver the SARAH programme to their patients, foreseeable barriers to implementing the SARAH programme, and their satisfaction with iSARAH are evaluated. Three NHS sites have just started SARAH service evaluation with six more sites to start after audit approvals. An institutional ethics review was not required for both evaluations. Result(s): As of October 17, 2017, 204 therapists have provided endof-training feedback. These findings are reported here: 182 therapists (89%) were females and 152 therapists (75%) were occupational therapists. 146 therapists (72%) have a graduate-level degree with 98 therapists (48.5%) having less than five years of experience in treating RA. 81 therapists (40%) have reported that they treat an average of 10-15 RA patients per month and 65 therapists (32%) treat less than five patients. 181 therapists (89%) have reported that they are confident in their ability to implement SARAH programme; 184 therapists (90%) intend to use it in their clinical practice; 149 therapists (73%) have foreseen lack of time, not seeing enough number of RA patients and difficulties with resources such as exercise equipment as key barriers for implementing the SARAH programme. 189 therapists (93%) have reported that they are very or extremely satisfied with iSARAH training. We will report the impact evaluation of iSARAH in 250 therapists and our preliminary findings of service evaluation at Rheumatology 2018. Conclusion(s): iSARAH has been a successful knowledge implementation tool in terms of introducing the SARAH programme to the targeted knowledge users and the positive feedback received so far. Reports on implementation barriers support the existing literature evidence that translating best new knowledge in the real world of clinical practice is challenging.