Translating Policy into Practice for Community-Based Management of Rheumatoid Arthritis: Targeting Professional Development Needs among Physiotherapists
Introduction. Contemporary health policy promotes delivery of community-based health services to people with musculoskeletal conditions, including rheumatoid arthritis (RA). This emphasis requires a skilled workforce to deliver safe, effective care. We aimed to explore physiotherapy workforce readiness to co-manage consumers with RA by determining the RA-specific professional development (PD) needs in relation to work and educational characteristics of physiotherapists in Western Australia (WA). Methods. An e-survey was sent to physiotherapists regarding their confidence in co-managing people with RA and their PD needs. Data including years of clinical experience, current RA clinical caseload, professional qualifications, and primary clinical area of practice were collected. Results. 273 physiotherapists completed the survey. Overall confidence in managing people with RA was low (22.7–58.2%) and need for PD was high (45.1–95.2%). Physiotherapists with greater years of clinical experience, a caseload of consumers with RA, postgraduate qualifications in musculoskeletal physiotherapy, or who worked in the musculoskeletal area were more confident in managing people with RA and less likely to need PD. Online and face-to-face formats were preferred modes of PD delivery. Discussion. To enable community-based RA service delivery to be effectively established, subgroups within the current physiotherapy workforce require upskilling in the evidence-based management of consumers with RA. 1. Introduction Rheumatoid arthritis (RA) is an autoimmune disorder associated with systemic inflammation and considerable societal and personal health burdens [1]. The evidence for physiotherapy to address impairment and disability associated with RA is well established [2, 3] and is recognised in clinical guidelines as an important component of overall effective management [4–10]. Recent projections point to a doubling in the prevalence of RA in Australia by 2050 [11]. This highlights the need to implement alternative and sustainable models of health service delivery to consumers with RA in order to maintain service quality and meet projected increasing demand, particularly in light of increasing service pressures being imposed on public tertiary hospital services. Contemporary health policy for care of consumers with chronic diseases, such as RA, promotes models of care where primary and tertiary care systems articulate to streamline health service delivery [12–15]. These service models emphasise the need to provide clinical services in community-based settings close to where
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