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March 16, 2022

Title: OACareTools: Resources for Healthcare Providers, Employers, and Adults with OA  

Presenter: Katie Huffman, MA

Director of Education & Outreach, OA Action Alliance
Thurston Arthritis Research Center, UNC-Chapel Hill

 

INTRODUCTION

(Julie Coleman) Hello, and welcome to the Osteoarthritis Action Alliance (OAAA) Lunch and Learn Webinar for March 16, 2022. Our presenter today is Katie Huffman. Katie has a master’s degree in Gerontology and has worked at UNC’s Thurston Arthritis Research Center for three and a half years.

She serves on the research team of Dr. Kelli Allen and is the Director of Education and Outreach for the Osteoarthritis Action Alliance. In her role with the OAAA, Katie has acted as the project manager for the OACareTools Companion Resource Development Initiative. Katie’s presentation today is entitled OACareTools: Resources for Healthcare Providers, Employers, and Adults with OA.

PRESENTATION

(Katie Huffman) Thanks Julie! Some of you may remember, in February of 2020…I don’t know, maybe not, that was certainly a long time ago and a lot has happened since then, but at that time I presented a Lunch and Learn called OACareTools: Engaging Primary Care Providers in Osteoarthritis Prevention and Management. I concluded that presentation with a slide title next steps where I outlined the OA Action Alliances desire to develop new patient resources, companion pieces for providers, and videos to further enhance the provider education toolkit. Fast-forward two years and I’m excited to tell you about how this vision…and then some…was turned into reality.

The purpose of today’s talk is to provide an overview of the OACareTools Companion Resource Development Initiative and to preview the new resources available on the OA Action Alliance website for Healthcare Providers, Employer Representatives and Adults and Employees with Osteoarthritis.

Here’s a quick overview of what I’ll discuss today. First a few disclosures, then I’ll present some statistics to show why OA matters and why we think these new resources are important. Next, I will provide a brief background of OACareTools and describe the Companion Resource Development Initiative. Finally, I will preview the new resources for each of the three main audiences.

The OACareTools Companion Resource Development Initiative was funded by Pfizer, and Pfizer collaborated in the development of the resources. The OA Action Alliance also received funding through a cooperative agreement from the CDC. Toolkit contents and companion resources are the responsibility of the OA Action Alliance and are based on best evidence and best practices in medicine. This presentation is intended to discuss educational resources about the arthritis disease state and no specific treatments will be discussed. Some of the materials on the OACareTools website were developed independently by the Osteoarthritis Action Alliance with funding from an independent grant from Pfizer in 2019.

Adapted from an infographic we created as part of the current Companion Resource Development Initiative, this slide shows some of the statistics that we believe explain why osteoarthritis is an important condition for healthcare providers and employers to consider. OA is the most common form of arthritis affecting one in seven us adults. It is a leading cause of disability among adults and more than half of people with symptomatic knee OA are of working age when joint replacement is required. OA is among the most expensive conditions to treat. It is also associated with increased comorbidities and other chronic conditions. Over 50% of people with OA have another chronic condition and over 30% of people with OA have five or more chronic conditions.

The graphics on this slide or from the original provider education toolkit show the relationship between OA, pain, and co-morbidities. OA can limit a person’s ability to self-manage other conditions like diabetes and hypertension, because pain from OA is associated with reduction to physical activity. All of this can result in a vicious cycle, where OA and its related pain and disability can contribute to the worsening of other conditions.

Then, in the context of the workplace OA symptoms may affect an employee’s ability to perform daily and work routines such as writing or typing, standing, or sitting for long periods, bending, and walking, or going up and down stairs. OA can also affect mental health and sleep. It is one of the most common causes of work loss and is costly for employers and employees. Work loss can come in the form of presenteeism where workers are less productive at work and absenteeism where workers miss more days of work, and OA can even lead to early retirement.

It’s clear that OA is prevalent in the US, it affects adults of all ages (not just older adults), and it can be costly for individuals, the healthcare system, and employers.

The OA Action Alliance has many resources already describing the burden of OA and the recommended prevention and management strategies, but we wanted to find a way to elevate this information to really make an impact far and wide to reduce the burden of OA.

 Many of our resources on the burden of OA and treatment recommendations are found in the original Provider Education Tool Kit or The Osteoarthritis Prevention and Management and Primary Care provider education toolkit, an existing base set of tools originally intended for primary care providers, which the OA Action Alliance completed in the fall of 2019.

The OA Action Alliance independently developed this toolkit with funding from a Pfizer independent grant for learning and change. The resulting toolkit has nine learning modules for primary care providers that are designed to help improve health care providers’ ability to recognize diagnose and treat. This is an example of a learning module in that original toolkit, and you can see it provides a lot of information, but providers must take the time to read it and distill the information.

Former stakeholders had requested we break that information down and enhance these learning modules with multimodal resources such as videos, infographics, action briefs, and PowerPoints. Additionally, while much of the information in this provider education toolkit could be used by other groups like employers or adults with OA, the OA Action Alliance wanted to increase engagement with those groups by developing materials on OA that were customized for employers, working adults, and individuals. So, to develop those expanded innovative resources, the OA Action Alliance partnered with Pfizer in a collaboration, known as the OA CareTools Companion Resource Development Initiative and it resulted in the resources that I’m going to share with you today.

In these new resources, our desire was to elevate the role of physical function in OA pain management and the use of the functional assessment and clinical care while also encouraging patient and employee engagement in self-management and shared decision-making opportunities. We propose to do that by developing practical tools, including videos, educational handouts, and PowerPoint resources to communicate key messages to providers and their patients, and employers and their employees. To start off this initiative, the OA Action Alliance created a stakeholder survey to identify gaps in OA understanding and resources among providers and employers, and to determine their preferred learning styles or formatting for that content.

We conducted an online survey for about six weeks and distributed that through our various communications channels and partner organizations. We received a total of 146 survey responses and went through those results carefully to learn what resources providers wanted for themselves and their patients, and what resources employer representatives wanted for themselves and their employees. The most surprising result from the health care provider survey was that providers were less interested in information on OA for themselves, and instead preferred tools to help them assess patients OA symptoms and functional abilities, as well as resources to help them engage their patients in OA self-management activities like weight loss, physical activity, and education.

Functional assessments were also ranked as a top gap in OA care and providers were looking for quick and easy tools and guidance on what performance measures are recommended. Considering results from the employer survey, it was clear that employers to have an interest in resources on OA that improve employee health and functioning, while some of the preferred resources for employers would serve the purpose of educating about OA like the healthcare providers. Employer representatives were interested in materials for themselves and their employees that focus more on reducing the impact of OA on employees work and personal lives.

Next, the OA Action Alliance convened an expert advisory panel to help interpret the results of the gap analysis survey and recommend direction for our content development. Our seven experts ranged from a variety of healthcare professionals to researchers, and we included one representative of the employer sector. Many of those seven stakeholders went on to be involved in writing and editing and even recording some of the resources. We used the gap analysis survey results and feedback from the expert panel to develop this matrix of proposed resources organized by topic area, format, and audience. From there, we got to work putting together the content for the resources.

It took us about a year to develop and design the 21 resources and we created a new section on the OA action alliance website where the resources are housed. This is a model of the new OA CareTools landing page. The OA CareTools companion resource development initiative has allowed us to expand OA CareTools so that now, in addition to the original Provider Education Toolkit or nine learning modules, we have these additional resources for health care providers, employers, and adults and employees with OA. These resources can all stand alone or be used in combination with each other.

Each audience has a landing page where their relevant resources are housed. So, if I click on health care providers, it takes me to this landing page. Our message to health care providers is that they can help reduce the burden of OA by expanding their knowledge of OA and its management using functional assessments in their practice, sharing resources with their patients, and promoting injury prevention strategies.

Now I’m just going to briefly highlight the resources included for healthcare providers, starting with the resources that inform providers about the clinical management of OA. This infographic shown on the left interprets recommendations from the ACR guidelines for the management of hand, hip, and knee OA. The video on right, developed and recorded by a pharmacist, explains the analgesics recommendations from the ACR guidelines.

These next two resources support healthcare providers in engaging patients and starting conversations about OA self-management strategies. The Exercise Rx for Arthritis resource provides guidance related to helping patients with OA create a joint friendly physical activity program. It has a patient facing resource and worksheet that can be used alongside of the program, and I’ll show that to you in a few minutes. And then, this is one of the two PowerPoint presentations we created as part of this project. The idea was that these presentations could be delivered by healthcare providers to their peers or learners in settings such as grand rounds, medical school lectures, or in their clinic staff meetings. The presentations can also be used for self-study. This presentation called engaging patients and OA management strategies highlights self-management strategies for OA and provides an example framework to help providers support their patients’ lifestyle changes. It also includes a speaker guide.

Another topic area for healthcare providers is functional assessments. On the left is an action brief, which describes the role of functional assessments and OA care. On the right is a video which features Matt Lowe, a nurse practitioner in Florida discussing the use of functional assessments in OA care. And then the second PowerPoint presentation we created for this project is on functional assessments. This presentation provides an overview of many functional assessment tools for OA that are currently used in clinical care and work settings, and it also includes a speaker guide.

This last resource was developed to address the gap analysis survey result where OA prevention rose to the top as the biggest gap in OA care. Within the topic area of prevention, weight management was selected as the most important topic to address. This one pager explains how OA and obesity are interconnected and suggests strategies that can help prevent and manage both diseases.

And then moving on to the resources for employers, the audience that we envision for these resources includes business advocates, benefits and wellness consultants, company managers and leaders, human resource representatives, and medical professionals seeing patients. Our message to employer representatives is that they can help reduce the burden of OA by expanding their knowledge of OA and its management: implementing arthritis friendly benefit plans, workplace policies, wellness, and safety initiatives, sharing resources with their employees, and promoting injury prevention strategies. From the employer representative on our expert advisory panel, we learned that employers would not necessarily be familiar with OA. He encouraged us to start with the basics and frame it within the context of a workplace setting. He suggested including information about health care costs, presenteeism and absenteeism, rates safety, and safety issues to consider. So that’s where we started.

The infographic that you can see here at left provides a general overview of OA including its impact on employees, its relationship to co-morbidities, and how it impacts employers’ bottom-line. And then the video at right highlights some of the financial costs of OA to employers and employees.

In this handout we wanted to educate employer representatives about the recommended treatment options for OA and give examples of ways that employers can help them, reduce the economic and personal burden of arthritis through their benefits plans workplace policies, and programs and safety initiatives that can be implemented.

Then we included all three of the functional assessment resources on the employer landing page for the attention mostly of occupational health providers. So, we have the action brief, the video, and then the PowerPoint with its speaker guide.

We also created a video on OA prevention shown on the left, which provides a public health approach to OA prevention, so it describes the importance of injury prevention and weight management, and strategies for preventing away. The video suggests some actions to help reduce the risk of developing OA for all age groups.

And then moving on to the resources for adults and employees, our message to this audience is that, even though away symptoms may affect their mobility, quality of life, ability to perform daily activities, and work routines, there are things that can help adults manage OA and we encourage them to explore our materials to find information on understanding their condition and managing their symptoms at home and work.

First, we have the work-related resources and the two resources here on the screen are meant to accompany each other. First there’s the video shown up left, which describes how joint pain and other symptoms can impact work tasks and daily activities. And it includes a few tips for managing OA in the workplace, and then the postcard on the right describes OA signs and symptoms and includes some more tips for managing OA at work. And the idea for this set of resources was that the video might be playing in a workplace lobby area or lunchroom and the postcard could be posted nearby for employees to take with them.

This resource is designed as a poster that can be hung in a break room or other common area or in the occupational health office and it informs employees about what OA is and how it can be managed in the workplace.

And here are some self-management focused resources, and these are relevant for all adults with OA, regardless of employment status. And the ones on this slide are another set. First, the handout on the Left describes resources and programs available for adults with OA to support physical activity, weight management, managing pain, self-care, social support, and medical care. And then the video on the right dives a little deeper into evidence-based programs describing physical activity and self-management education programs that may be available in the community.

This infographic describes strategies that can help adults manage their joint pain, regardless of how they spend their day. And this resource was designed to describe the recommended OA treatment strategies for adults and then go a little further by considering how people spend their day, whether that’s mostly seated, standing, walking, or doing heavy labor. Then we included some strategies for each of those types of lifestyles.

This resource has information on the front explaining how adults with OA can get started with a joint-friendly physical activity plan. Then on the back is a worksheet where they can do some goal setting around physical activity. This is the resource I mentioned earlier, which could be used as a companion to the providers exercise prescription for arthritis handout.

And this video is one of my favorite resources that we developed during this project. It features Rota, a patient with OA, and Dr Nelson, a rheumatologist, talking about strategies for managing OA and improving function at home and at work.

And then Lastly, on the topic of OA prevention, we include this video that I described earlier, which uses a public health approach to relay the importance of injury prevention.

So that wraps up 20 of our resources. And I’ll get to the 21st here in a minute, but now that we’ve created these resources, we really hope that they will be used by employers and healthcare providers. So, using comments we’d heard on the original provider education toolkit and then reviewing input from our gap analysis survey and getting recommendations from our expert advisory panel, as we developed the topics and content for the resources, we had in mind how they might be used in practicality.

For employers, we envisioned they might, as I described earlier, they might play the videos in common areas and display print resources nearby. They might distribute the employee resources at a health fair, display posters or handouts in break rooms, or in the occupational health office if they have one. And then we hope they’ll use the employer education pieces when discussing benefit plans, wellness programs, and safety programs.

We hope health care providers will use the handouts to tell their patients about programs and resources for adults with OA. They can certainly use the various handouts, the physical activity worksheet to help their patients create a plan. We can imagine they might display the patient resources and clinic waiting areas or in clinic rooms and then with PowerPoint presentations and speaker guides. We hope to both encourage peer to peer education around the topics of OA self-management and functional assessments, but also help facilitate conversations among providers about how those practices and those assessments could be used in their clinic setting.

We launched these new resources in early February, and we are grateful to our many friends and partners for their efforts to promote them alongside our efforts. To help with our partners promotional efforts we developed a media kit, you can see this purple button at the bottom of the toolkit homepage, and it takes you to our media kit. And that features readymade Facebook, Instagram, LinkedIn, Pinterest, and Twitter graphics we have pre-drafted, social media posts, and approved language for newsletters emails and websites. You can see a couple of the simple social media graphics here on this slide

And then the 21st resource is a brochure that describes the contents of these new resources, so we hope that this can be used as a promotional tool as well. This brochure could be handed out at professional conferences meetings or other settings where groups of employers or health care providers might be gathered. It can also be shared with patients and employees to encourage them to go to the site and use the resources.

And we hope that you will leave today’s presentation thinking of at least one person or one organization that might benefit from knowing about these resources, and we hope you’ll help us spread the word…send them a link or post about it on your social media pages, or something similar. We really appreciate your partnership and your support to help get this information out to the people who might be able to use might be able to use it.

So that’s the end of my presentation I’m happy to answer any questions you might have about these new resources.

 

QUESTION AND ANSWER

Julie Coleman) Thank you Katie, it was wonderful to see how thorough you all are were with your process and just everything that went behind the CareTool development…great.

And we do have time for a couple of questions, just a reminder anybody can type A question that you have into the chat box at any time. Also, in a few minutes, you will see a poll pop up on your screen, with some survey questions, so please answer those before you leave the webinar.

QUESTION: Katie, I was wondering if you could tell us about some examples of things that employers can do to make their workplace more arthritis inclusive.

ANSWER: Katie Huffman: Yeah, that’s a good question, and it gets a little into some of the information that we have included in in the resources so I’ll just give you a taste now, and then hopefully you can check out some of the resources we create it for employers on that topic.

There are quite a few policies and programs that employers can implement to support their employees with OA or to help employees prevent even developing the condition. One example is reducing the need for movements in the first place, like heavy lifting, squatting, kneeling, climbing, things that might increase the risk of developing OA or that might make OA symptoms worse for people who already have the condition. That can be done by bringing in special equipment like lifts or tractors to help do some of the tasks that people were doing manually before, or employers can develop policies that allow employees with joint pain to switch to fewer demanding jobs or to have, maybe even alternate schedules. Then outside of that, employers can encourage work breaks, activity pacing, walking meetings is a is a good one. One thing that I know a lot of employers are already doing is providing assessments where experts will come and look at employees’ job duties or even their job environment and make recommendations about assistive devices like standing desks, or lumbar supports for chairs, or other accommodations that will help them do their jobs, more easily and with less pain. Another thing employers can do is when they’re you know thinking about their benefits plans or wellness programs just to remember osteoarthritis, and that many of their employees may have that condition or make sure that some of the treatments for OA are included in their plan, whether that’s certain medications or supportive devices like hand and knee braces and even including evidence-based physical activity programs…like providing those on site or providing access to walking trails or two gyms since physical activity is so important for people with OA.

QUESTION: And I think just a follow up to that quickly, a lot of what you were talking about sounded like it would be transferable to the home-work place. Do you think there’s anything else, you know as we’ve transitioned to working at home that you would suggest, as just a once-over for employees?

ANSWER: Katie Huffman: Yeah, I think probably at home, it may even be more important to provide assessments for employees or to provide an allowance, even for them to get equipment that might make them more comfortable at home. I must be honest, for myself, I sit, a lot more when I’m in my home office than when I’m in my employer’s office space and it’s painful! So, I think you know even having a chair or desk at home that provides me the same comfort that I have at work, and you know, having encouragement from an employer to you know make time in the day to be physically active or encouraging employees to set reminders for themselves to stand up periodically. I think even you know working at home, it might be even more important to encourage employees to be comfortable and to move more and take less worry less about their pain.

Julie Coleman: Yeah, I think that’s something we can all relate to, and I appreciate your perspective on it. With that, I think that’s everything we have for today’s presentation! Again, if you all could just make sure that you use the pole that’s going to be launched onto your screen right now that will be great. And please join us next month for the April 20^th Lunch and Learn featuring Nick Beresic from the OA Action Alliance who will present on How Climate Change May Affect the PA Guidelines in the Future. Thank you very much and have a great rest of your day.