The Impact of BritPACT

Research

 

Ongoing collaborative projects within BritPACT

Following the inaugural “Emerging Frontiers in PsA” meeting on 14th October 2015, a number of potential research and educational priorities were developed with the attendees of that meeting. Further survey work with the membership and steering committee has aimed to prioritise these unmet needs to inform the future collaborative projects in BritPACT.

 

Rheumatology editorial

Led by Dr Jon Packham, the steering committee published an editorial in Rheumatology outlining the role of BritPACT and the potential advantages to an independent network of PsA researchers in the UK who could lead on research and educational activities.


Support for MONITOR-PsA “Trials Within Cohorts”

Following an email to the BritPACT membership, five BritPACT members volunteered to support the Multicentre ObservatioNal Initiative in Treat to target Outcomes in Psoriatic Arthritis (MONITOR-PsA) study by serving as independent members of the Trial Steering Committee and Data Monitoring and Safety Committee. This study is running at the Universities of Oxford, Bath, Cambridge, Newcastle and Coventry and Warwick NHS Trust led by Dr Laura Coates.


Barriers to T2T qualitative research

Led by Dr Laura Coates (University of Oxford) and Dr Emma Dures (University of West of England), BritPACT have collaborated in a project to address the barriers and potential facilitators to implementation of a treat to target approach in PsA. This project ran through 2018 and 2019 and used qualitative research methods to explore the implementation gap in this field. In total, 10 BritPACT members took place in one-to-one interviews and 9 took part in a focus group held in March 2019.  The study identified a number of potential barriers: an overarching theme of ‘Complexity’, which incorporated three themes of ‘PsA versus RA’, ‘Measurement’, and ‘Resources’. An underpinning theme of ‘Changes to current practice’ captured the tension between themes of ‘Reluctance due to organisational factors’ and ‘Individual determination to make changes.’ The data were presented at the American College of Rheumatology Annual Meeting in Atlanta in November 2019 and will be submitted for publication in late 2019 or early 2020.


Raising awareness of HQIP data

Analysis of the BSR HQIP audit data addressing outcomes in PsA was performed by Professor Neil McHugh and his team at Bath. Once this is published, BritPACT are aiming to raise awareness of this research highlighting the delay in diagnosis and impact of PsA in the UK.


Radiographic features of PsA

Dr Nicola Gullick and Professor Bruce Kirkham have proposed a project to investigate radiographic features of PsA in collaboration with a radiologist developing new analysis techniques. We hope to facilitate this research, identifying investigators and centres to participate and the ideas behind this project will be presented at the 2019 Annual Education and Training Day on Friday 22nd November 2019.


 

Education

Annual Education and Training Day on PsA

BritPACT have hosted an annual education and training day on psoriatic arthritis since the first in 2015.  The attendance at these meetings has increased year on year with over 60 registered delegates.

In 2017, the BritPACT annual meeting was held in Birmingham in collaboration with the Brit-SpA annual meeting.  The groups maintained separate meetings but also hosted a combined session and dinner with presentations on all aspects of spondyloarthritis and a lively pre-dinner debate.  The agenda is available here.

Consensus-based Best Practice Statements

Starting in 2018 and led by Dr William Tillett, BritPACT will be developing consensus based best practice statements to help physicians integrate current national and international treatment recommendations with practical advice on optimising patient care. We aim to cover topics including screening, diagnosis, assessing prognosis, assessment of disease activity, management and comorbidities.


 

PSP

In 2019, a Psoriatic Arthritis Priority Setting Partnership (PSP) has commenced aiming to identify unmet needs in psoriatic arthritis.  This is being funded by BritPACT and led by Dr Laura Coates from the University of Oxford, in collaboration with the British Society of Rheumatology (BSR), Psoriasis Association and the Psoriasis and Psoriatic Arthritis Alliance (PAPAA).

The project follows methods set out by the James Lind Alliance and have been used for many different conditions. In 2020, the first step will be to ask everyone affected by psoriatic arthritis – individuals who live with the condition, their families and friends and the clinicians who treat them what they perceive to be the unmet needs in psoriatic arthritis via a large online survey.  We will ask them to submit key research questions that they want to see addressed.

Next, the steering group will collate these. Similar questions will be grouped together, and the wording summarised. The steering committee will check to ensure that these questions have not already been satisfactorily addressed by research studies.  Any questions that are found to have already been answered by existing research studies, will be collected together to share with healthcare professionals and research organisations so that they can think about how to better communicate this information to healthcare professionals and the public.

Then a second (shortlisting) survey will be performed, again with all people affected by psoriatic arthritis invited to take part, and respondents will be asked to pick their top questions that matter to them most up to a maximum of ten questions.

After the results of this second survey are available, people with psoriatic arthritis, their families, and healthcare professionals will be invited to a final workshop to discuss and rank the most popular questions from the survey, producing a final 'Top Ten' list.  This list of priorities will help to inform researchers and research funders working in the area of psoriatic arthritis, so that, in future, work is done in areas that are deemed most important.

Click to download the terms of reference and the protocol.

 

James Lind Alliance

The James Lind Alliance (JLA) is a non-profit-making initiative, established in 2004. It brings patients, carers and clinicians together in Priority Setting Partnerships (PSPs), the aim of which is to identify and prioritise uncertainties, or ‘unanswered questions’, about the effects of treatments and interventions in different health conditions, topics or settings.

The JLA believes that addressing uncertainties about the effects of treatments or interventions should become accepted as a much more routine part of clinical practice, and patients, carers and clinicians should work together to agree which, among those uncertainties, matter most and thus deserve priority attention.

The JLA is funded by the National Institute for Health Research (NIHR) and is coordinated through the NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC). To find out more about current and past PSPs, please visit www.jla.nihr.ac.uk.

 

PSP Committee

Suzannah Kinsella

James Lind Association Advisor

James Lind Association

Laura Coates

Rheumatologist

University of Oxford

Jon Packham

Rheumatologist and BSR representative

 

Philip Helliwell

Rheumatologist

University of Leeds

Sandeep Mukherjee

Rheumatologist

Bournemouth and Christchurch NHS Hospitals Trust

Helen Burstow

Rheumatology Specialist Nurse

Bournemouth and Christchurch NHS Hospitals Trust

Christine Bundy

Psychologist

University of Cardiff

Helen Young

Dermatologist

University of Manchester

Elspeth Wise

General Practitioner

 

Helen McAteer

Psoriasis Association representative

 

David Chandler

Psoriasis and Psoriatic Arthritis Alliance representative

 

Russ Cowper

Patient representative

 

Lucille Joannes

Patient representative

 

Bronagh Kennedy

Patient representative

 

Andy Kelly

Patient representative

 

Charlie Anderson

Patient representative

 

 

PSP partners

We are delighted that the following organisations support and have agreed to help promote the Psoriasis PSP to their networks:

  • British PsA Consortium (BritPACT) – also funders
  • British Society for Rheumatology (BSR)
  • Psoriasis Association
  • Psoriasis and Psoriatic Arthritis Alliance (PAPAA)
  • Bath Institute for Rheumatic Diseases (BIRD)
  • Royal College of Nursing
  • Musculoskeletal Association of Chartered Physiotherapists (MACP)
  • Primary Care Rheumatology and Musculoskeletal Medicine
  • Podiatry Rheumatic Care Association (PRCA)
  • Arthritis and Musculoskeletal Alliance (ARMA)
  • National Rheumatoid Arthritis Society (NRAS)
  • National Axial Spondyloarthritis Society (NASS)
  • Arthur’s Place
  • Barbara Ansell National Network for Adolescent Rheumatology (BANNAR)