P002 Implementation of a new digital exercise tool in axial spondyloarthritis and a musculoskeletal therapy outpatient department: a service evaluation
Authors: Tomkins Jacqui , Wallis Dinny 
Published: April 2023

Abstract

Background/Aims
National and international recommendations for the management of axial spondyloarthritis state the importance of providing exercise advice. Furthermore, the NHS digital plan highlights the need for virtual consultations, which was supported by patients’ preferences in our Trust. With a focus on supported self-management and in conjunction with the ‘Aspiring to Excellence' programme, we explored the optimal way of digitally communicating exercises with our patients.

Methods
In July 2020, partly in response to a reduction in face-to-face appointments due to infection risk, Physiotec (an online digital platform which allows the creation of personalised web-based exercise programmes) was introduced into the rheumatology and therapy outpatient departments. Between July and September 2021, paper and online surveys were sent to patients and online surveys sent to staff, to discover the views of patient and staff users of this programme.

Results
Data were analysed between July 2020 and July 2021. 41 therapists had used Physiotec, a maximum of 28 staff users at any one time. 21/28 therapists had logged on in the previous 30 days. 3245 exercise programmes had been created in total for 2553 patients. Ratio of patient: therapist ranged from 0 to 217; mean 58; median 40. Patient comments about Physiotec included: “absolutely first class”; “easy to understand”; “tailored to individual needs”; “easy to access”; “environmentally friendly” and “a great prompt”. They liked being able to see their exercises in action through the videos. Patient surveys (n = 68) revealed that Physiotec was used equally across all mediums of therapy consultation: face-to-face, video and telephone. Furthermore, 53% of patients had been given information in a digital format, compared to 1% in 2019. 65% of patients requested that they would like information to be provided in a digital format, compared to 36% in 2019, with 32% specifically requesting an app such as Physiotec. All therapists (n = 24) agreed or strongly agreed that Physiotec should continue and gave it a mean 4.5/5 star rating. Remarks included: “quick and easy to use”; “good variety of exercises”; “helpful for new therapists in devising treatment plans”. They found it to have superior features to previously used digital exercise tools and that, helpfully, paper copies could be printed. Negative comments included that certain exercises were not listed and “technology issues”.

Conclusion
Physiotec is a highly valued digital exercise tool amongst patients and therapists, supporting self-management. Some patients still prefer paper handouts, which is possible from this digital tool and patient choice remains at the heart of how we deliver our services. As digital technology is a fast-developing area, Physiotec will be re-evaluated in 2 years’ time to decide if it still meets the needs of our patients.
Disclosure
J. Tomkins: Grants/research support; Physiotec was funded by Novartis and UCB, this work was supported by the ‘Aspiring to Excellence' programme. D. Wallis: Grants/research support; Physiotec was funded by Novartis and UCB, this work was supported by the ‘Aspiring to Excellence' programme.