OA31 Moving forward with fibromyalgia: a collaboration between NHS Greater Glasgow and Clyde and Renfrewshire Health and Social Care Partnership
Authors: Collins Fiona M 
Published: April 2024

Abstract

Background/Aims
Fibromyalgia is a condition defined by a number of symptoms including the presence of widespread chronic pain, fatigue, poor quality sleep, cognitive symptoms and depression. The UK's Getting it Right First Time programme recommends that management of people with fibromyalgia should centre on primary care, but it remains unclear how best to organise health systems to deliver services to optimise patient outcomes. Within NHS Greater Glasgow and Clyde (NHSGGC) there was no consistency with how these patients were managed, but Clyde rheumatology physiotherapy had an innovative hospital-based programme which proved to be the model for "Moving Forward with Fibromyalgia".

Methods
A programme was developed between NHSGGC and Renfrewshire Health and Social Care Partnership (Renfrewshire HSCP) using monies from the Primary Care Transformation Fund. A physiotherapist from NHSGGC coordinated the programme and delivered information and advice on managing fibromyalgia using written, video-based and online resources. Instructors from Renfrewshire Leisure delivered 8x weekly sessions of tai chi. GPs make the initial diagnosis based on ACR diagnostic criteria and then make the referral. Patients are not required to be referred to secondary care. Patients then receive a telephone consultation with a physiotherapist prior to being appointed to an 8 week programme. This allows them to discuss their diagnosis, which many report as being very useful and reassuring. Tai chi was selected as there is a growing body of evidence that it is both suitable for and well tolerated by people with fibromyalgia. The programme began in 2019 with the aim to run for two years but, due to COVID, it has been extended to run until March 2024.

Results
So far, 710 patients have been referred to the programme. The Fibromyalgia Impact Questionnaire (FIQ) and Measure Yourself Medical Outcome Profile (MYMOP) questionnaire are completed prior to starting the programme and again on completion. Fibromyalgia programmes historically have high levels of drop out - before and during COVID we had only 44.1% participation. However, since resuming face to face programmes post-COVID, our participation has increased to 60%. FIQ scores were shown to improve in 60% of cases, and MYMOP scores improved in 67.5% of cases. The majority of patients who completed the programme felt good benefit from attending: "Initially sceptical but love it." "Very useful." "Absolutely fabulous."

Conclusion
The programme is enjoyed and felt to be beneficial by most patients who complete it. Treating these patients in a community-based setting reduces the demand on secondary care and hopefully has a similar effect on primary care resources. It also means that they are managed by people familiar with fibromyalgia. Many patients say that being part of a group is as important as any exercise. The programme has potential to be rolled out more widely to offer a service to a patient group who often feel forgotten or neglected.

Disclosure
F.M. Collins: None.