P073 Interactive rheumatology biologic self-injection video advice using an SMS based video resource: successful implementation during a pandemic
Authors: Mistry Pritesh , Bateman James , Hughes Kay 
Published: April 2021

Abstract
Background/Aims
The COVID-19 pandemic has resulted in a number of changes in practice in the UK, including the reduction in routine day-case attendances for intravenous rheumatology treatments. Due to redeployment and resultant staff shortages, we required alternatives to day case attendance. The usual face-to-face education that normally supports this was not possible.
Methods
In March 2020, we identified patients receiving monthly intravenous tocilizumab on our day-unit and planned a supported transition to weekly subcutaneous self-injection. We designed, planned, storyboarded, video-recorded, and piloted a 15-minute tocilizumab self-injection interactive video resource, using evidence-based educational methodology. This included: an introduction; explanation of the change and context; a one-minute video of our nurse specialist self-administering a sample injection; a close-up injection video; local logistical information and contact details, and a voluntary anonymous web-based evaluation. The interactive resource was searchable and contained links to supporting information, including a link to manufacturer patient education material. The intervention received rapid institution and pharmacy approval for distribution. We sent it via SMS message to our cohort of patients using a commercial partner (HealthComm UK) from 8.4.20, using an established method we have recently described. Simultaneously, we made it publicly available on our departmental website. We collated feedback and usage metrics over an eight-week period (8.4.20 - 3.6.20).
Results
We identified 69 patients eligible to switch to self-injection; all were sent the SMS link. Our resource was viewed by 39/69 patients (57%) via the unique SMS link, a total of 97 times (mean 2.5 views/patient). Others watched it on our website, 534 views, by 283 unique visitors (1.9 views/visitor). In total, 24/69 patients (35%) returned a complete evaluation of the video, 16/24 (67%) felt more confident injecting after watching the resource. Age ranges in deciles (number) was: 40-49, (5); 50-59, (6); 60-69, (8); &gt;70, (5). Likert scores for satisfaction with the resource (1=strongly disagree; 5=strongly agree) were as follows: video ease and playback (4.1); improved confidence of self-injection (4.0), usefulness of SMS methodology (4.3), usefulness of interactive resource over video (3.7). A number (9/24, 38%) had never self-injected any medicine. Most completing the evaluation (18/24, 75%) viewed the resource on mobile phones. Written feedback, where given, was positive in 18/19 (95%) cases, one patient identified they could not watch the video.
Conclusion
The COVID-19 pandemic has increased the use of telerheumatology resources. We have demonstrated that interactive video resources are a rapid, acceptable, and useful method of delivering rheumatology education. This intervention is low cost (£0.01 per SMS) and we used existing e-learning technology already licensed to our hospital at no additional cost to the department, other than staff time. Our findings have implications for other aspects of rheumatology self-care and we call for further research in this area.
Disclosure
P. Mistry: None. J. Bateman: None. K. Hughes: None.