SAT0769-HPR Do patients recall physical activity advice? interviews with uk inflammatory arthritis patients to explore experiences of physical activity communication
Authors: V Salmon, N Walsh, E Dures, A Haase, M Urban, F Cramp
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Guidelines for managing inflammatory arthritis (IA) indicate that patients should be encouraged to be physically active. Patient perceptions of physical activity (PA) communication during routine rheumatology consultations, or whether they recall or understand PA information, are not known. <h3>Objectives</h3> 1. To explore patients9 short-term recollection and interpretation of communication relating to PA during consultation with a rheumatology doctor or nurse 2. To explore patients9 needs for effective PA communication <h3>Methods</h3> Adults with IA took part in semi-structured telephone interviews 2 to 3 days after their consultation with a rheumatology doctor or nurse. Transcripts were analysed using thematic analysis. <h3>Results</h3> 26 patients took part (18 female; age 35–83 years; disease duration 0.25–40 years). Preliminary analysis suggests five themes: <i>Patients recall little communication about PA:</i> Few patients recalled PA communication during their appointment, although some discussed general lifestyle and some recalled discussions about PA or exercise in previous consultations. <i>Appointments focus on medical management:</i> Patients mainly recalled discussing medical management of IA. Some were asked about general health and support needs, but assumed health professionals were interested in disease status and medication rather than lifestyle and wellbeing. <i>Patients are uncertain as to what constitutes PA:</i> Some patients seemed confused by what constituted discussion about PA. Different interpretations were reported, with many participants referring to condition specific exercises rather than lifestyle PA. Few patients described PA as general movement or everyday activity. <i>Patients would like to discuss PA:</i> Few patients initiated conversation about PA, but many would welcome PA communication from any health professional with appropriate knowledge. Several patients felt most comfortable discussing PA with a member of their rheumatology team rather than a non-specialist. A small number felt the rheumatologist9s role related to medical management rather than lifestyle advice. Preferences for communication style included a direct, honest approach using lay language. It was felt that health professionals could do more to ask about and encourage PA, reassure about PA safety, and offer individualized support to enable appropriate PA. <i>Perceived barriers to undertaking PA must be considered:</i> Some patients perceived barriers to PA, such as lack of knowledge and skills for PA, lack of time, work commitments and IA flares. It was felt important to acknowledge that it can be difficult to apply lifestyle changes in practice. <h3>Conclusions</h3> IA patients recalled little discussion about PA in routine rheumatology consultations. Patients may interpret questions about general health and exercise as relating to their disease status and joint function rather than to lifestyle or PA. Health professionals should ask direct questions about lifestyle PA and offer non-didactic, individualized advice and support. Further research is needed to understand PA communication from the perspective of rheumatology health professionals, including identification of opportunities and challenges for implementing effective communication. <h3>Disclosure of Interest</h3> None declared