Supporting people with musculoskeletal disorders in Scotland to remain in work (Making it Work™ - Scotland)
Adapting the Making it Work™ intervention developed for people with inflammatory arthritis in Canada
Musculoskeletal conditions affect around 1 in 3 Scottish adults and have a substantial impact on individuals’ work. There is a lack of services supporting individuals with long-term conditions to remain working if they wish to do so. Making it Work™ is an online self-management programme developed in Canada which supports people working with inflammatory arthritis. The programme has been successful in helping individuals feel more capable to meet work demands and has reduced the likelihood of extended sickness absences.
Our team will seek input from patients, employers, and healthcare professionals on aspects of the programme to modify and expand in order to make it relevant for people with a wider range of musculoskeletal conditions in Scotland, including non-inflammatory conditions such as osteoarthritis, fibromyalgia and chronic pain. Based on this feedback we will make changes to the programme and establish how it can be delivered within NHS Scotland.
Background
Musculoskeletal conditions have a substantial impact on individuals’ lives including their work participation. They impact on people’s productivity at work and, after minor illnesses, they account for the greatest number of days of sickness absence in the UK. Importantly, reduced productivity and sickness absence are both associated with a higher risk of subsequently withdrawing from work. Supportive work environments are important for helping individuals with musculoskeletal conditions to maintain healthy working lives, however, there are specific work challenges for people with long-term musculoskeletal conditions and patients have highlighted that support to work often remains an important unmet need. While pain and symptom management programmes exist, specifically managing challenges at work is not usually addressed within these programmes.
The Making it Work™ programme was developed in Canada to support individuals with inflammatory arthritis (such as rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis) to stay in work for as long as they wish to do so. Making it Work™ is a self-management programme consisting of five online modules including educational material and interactive activities which cover topics related to arthritis and employment, such as managing fatigue and stress at work, and building supportive working relationships.
This programme has been shown to help individuals feel better able to meet their work demands, and reduced the likelihood of prolonged sickness absence .
Aims
We intend to adapt the Making it Work™ programme so that it is relevant for people working with a larger range of musculoskeletal conditions and to adapt its delivery to the Scottish health and social care context. We plan to expand the programme to people with fibromyalgia, osteoarthritis, and chronic regional and widespread pain which represent common and disabling non-inflammatory musculoskeletal conditions in Scotland.
What will this research involve?
In order to adapt the programme to this wider context, we will carry out three distinct pieces of research work (called workpackages)
Workpackage A
We will first conduct a mapping exercise in order to review the existing programme, and to begin to identify key areas where we think the existing Making it Work™ needs to be changed.
We will then conduct a series of focus groups with patients, employers and healthcare professionals in order to get their input into which aspects of the programme are likely to need changed, including:
Exploring ideas s about how to develop or adapt the programme so that it is relevant for people with non-inflammatory conditions as well as inflammatory conditions
Identifying which aspects of the current programme are specific to the Canadian health and social care context and how these might be updated or adapted to fit the UK healthcare and legislative environment
Understanding where the programme could be tailored in order to meet the needs of ‘non-traditional’ form of employment, such as freelance work or zero-hours contracts, as well as changes in working practices brought about by the COVID-19 pandemic.
Workpackage B
Once we know how the programme will need to be adapted, we then need to consider how this will be most effectively delivered. Through a series of focus groups with healthcare professionals most likely to be engaged in the programme’s delivery pathways, as well as members of third sector organisations, we will seek to identify the optimal referral pathways to the programme, the healthcare professionals may be best placed to deliver the programme, any implementation barriers and facilitators, and any issues affecting organisational capacity which could facilitate the delivery of the programme within NHS Scotland.
Workpackage C
Finally, we will engage with content creators, eLearning specialists, and media producers in order to produce revised content for the updated programme based on considerations identified in workpackages A and B.
We will then assess the acceptability, relevance, and usability of the modified programme by running evaluation with patients with inflammatory and non-inflammatory musculoskeletal conditions working in Scotland in order to assess the suitability of the new programme.
We expect to then take this work forward into future research designed to assess the effectiveness of the Making it Work™ - Scotland programme, as well as looking at how this could be implemented more broadly throughout the UK.
What has the study found so far?
We have now completed our initial programme mapping and have completed the focus groups within Workpackage A. These focus groups helped us to identify key changes to take forward within the adapted programme, and we are now busy incorporating these changes. We are also engaging with e-learning experts and patient partners to redesign the look and feel of the programme to modernise its design.
Once papers from this research have been published they will be made available here.
Study team
Chief investigator
Professor Gary Macfarlane (University of Aberdeen)
Co-chief investigator
Dr LaKrista Morton (University of Aberdeen)
Co-investigators
Dr Rosemary Hollick (University of Aberdeen)
Dr Elaine Wainwright (University of Aberdeen)
Dr Diane Lacaille (Arthritis Research Canada)
Associated research staff
Dr Cara Ghiglieri (University of Aberdeen)
Mr Stuart Anderson (University of Aberdeen)
Centre institutions
Research partners
Further information
If you want further information you can visit the Making it Work™ - Scotland study page at the University of Aberdeen.
If you have any queries for the study team, you can contact us at makingitwork@abdn.ac.uk