OP0158 HPR THE BARRIERS AND FACILITATORS TO REQUESTING AND RECEIVING PSYCHOLOGICAL SUPPORT FOR PEOPLE WITH RHEUMATOID ARTHRITIS AND ADULTS WITH JUVENILE IDIOPATHIC ARTHRITIS
Authors: Hayley McBain, Matthew Bezzant, Ailsa Bosworth
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> UK guidelines<sup>1-3</sup> state that psychological interventions should be offered to people with rheumatoid arthirtis (RA) to help them adjust. Although rheumatology units recognise that providing psychological support is part of their role, 3 in 4 rate their overall provision as inadequate.<sup>4</sup> The reasons being a lack of time, a lack of trained clinicians and available training and the costs of delivering this type of service. However, little is known about the barriers to requesting psychological support from the patient perspective. <h3>Objectives</h3> To establish the full range of barriers and facilitators to requesting psychological support. <h3>Methods</h3> The 2018 National Rheumatoid Arthirtis Society (NRAS) 'Emotional Health and Well-being Matters' survey was designed by patients and researchers. This included a questionnaire designed to capture the barriers to accessing psychological support, using an established theoretical framework.<sup>5</sup> The questionnaire consisted of 41 items covering a range of barriers, with responses on a 5-point Likert scale. Participants were recruited by NRAS via their social media platforms, membership and non-membership lists through direct mail and in newsletters and the NRAS HealthUnlocked forum. The survey was open from May-July 2018. Recruitment was those diagnosed with RA and AJIA, aged 18 years and over and living in the UK. <h3>Results</h3> A final sample of 1650 participants took part in the survey, 97% of the sample had RA and 3% AJIA. 1 in 5 people with RA and 1 in 10 with AJIA were unlikely or extremely unlikely to seek psychological or emotional support in the future, even if they felt they needed it. The most frequently reported barriers to requesting psychological support from their healthcare team were (i) lack of optimism about their future with RA or AJIA (ii) not knowing what support they can access (iii) finding it difficult to talk about their emotions and asking for help (iv) believing healthcare professionals lack the time and ability to help them (v) believing that discussing emotions and providing psychological support is on not on their healthcare team's agenda, evidenced by a focus on physical rather than psychological health in consultations and (vi) never or rarely being asked about their emotions. <h3>Conclusion</h3> Exploring the potential barriers to requesting psychological support has given us unique insight into the complex journal of receiving psychological support. To overcome the most influential barriers steps need to be taken to encourage hope for the future, empower patients with RA and AJIA to talk about their emotions and instigate these discussions with their healthcare team, as well as providing more information and guidance about what support they can access and from where. <h3>References</h3> [1] National Institute for Health and Care Excellence. Rheumatoid arthritis in adults: management NG100. 2018. London, NICE. [2] Luqmani R, Hennell S, Estrach C, Birrell F, Bosworth A, Davenport G, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of rheumatoid arthritis (the first two years). Rheumatol 2006; 45(9):1167-1169. [3] Luqmani R, Hennell S, Estrach C, Basher D, Birrell F, Bosworth A, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of rheumatoid arthritis (after the first 2 years). Rheumatol 2009; 48(4):436-439. [4] Dures E, Almeida C, Caesley J, Peterson A, Ambler N, Morris M, et al. A survey of psychological support provision for people with inflammatory arthritis in secondary care in England. Musculoskeletal Care2014; 12(3):173-181. [5] Francis JJ, O'Connor D, Curran J. Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implement Sci. 2012;7:24. <h3>Disclosure of Interests</h3> None declared