Hello ,


I have posted this here as the email newsletter asked for feedback but did not say where to send it :)

Well I have just gone through the RA PDA , and I must say I am reasonably impressed , and wish this was available when I was first diagnosed over 2 Years ago.

The decision tool does make it clear that it is for people who have been recently diagnosed, however it also reveals options that would be of use at any stage during treatment.


Gives 3 options for treatment , one of which (Supportive therapy and symptomatic treatment) should really be done in tandem with a choice from either single drug treatment or multiple drug treatment, which are the other 2 options.
You really have to click on every possible link to get the most from the site.

I like the fact there is a bar at the top of the screen that lets you see where you are in the PDA and you are able to progress using that or the continue/back buttons.Love the fact that if you register you can save notes that will be on the printout and in effect you can take the whole decision process to your Consultant/Nurse appt.

In part 2 i like the way you can quickly compare the three given options .

In part 3 (my values) i am always wary of multiple choice expert systems that come up with advice or recommendations , however in this case no matter what you put in this page ,the answers in "Trade Offs" err towards recommending early use of DMARDS.

I am concerned about the use of Green , Yellow and RED backgrounds for the agree/disagree answers , as this psychologically suggests that the red background is the wrong route to take.( I think this is a huge issue and should be thought out again!)

In part 5 it only lets you choose one option , when in reality a patient would probably need SUPPORTIVE THERAPY AND SYMPTOMATIC TREATMENT as well as one of the other options , .

Printouts are good ..if you select the left hand "all" , then all the information on the site is printed , including the references for statements in the body of the website. This amounts to 20 pages .

I would also like to see links from specific drug names to patient .co.uk and more importantly a PDA for longer term RA sufferers and Biologic/ anti TNF choices.

Also on the same site i found the "For Health Professionals " links and that had PDF's of the main choices on a formatted printed sheet , and i think i would like to see this as an option for the patient as well ...see http://sdm.rightcare.nhs...decision-making-sheets/

I see someone has commented on this forum that they are fuming because the PDA states that MTX and the like can help with depression. I agree to some extent and do feel that anti depressants have their uses , but not maybe at the outset since the PDA is for newly diagnosed sufferers.
My depression has , i believe, come about after slowly losing my abilities over time , and Nortriptyline does help with this until my RA treatment is effective.

I did not call the "Decision Support " but i think it would make an interesting "Mystery Shopper " exercise , perhaps NRAS would be interested in doing that ,especially considering Ailsa Bosworth was a contributor.

Using these will be a massive culture change to a lot of Consultants and CCG's but it appears that there will be a training programme . It remains to be seen whether the culture can be changed within the NHS.


I am more than a little concerned that Capita are involved in this


Regards

Rich

hehe
Capita are taking over Public Services in the form of Local Government /Education/Defence/Central Government/Police/Housing and now the NHS . They also will be providing Assessment services for Personal Independence Payments together with ATOS , which you could argue is a conflict of Interest.

We had the same situation with ATOS , providing Occ Health Services for companies like Royal Mail, deeming someone to be unfit for any job in the Royal Mail then ATOS finding them fit for work for ESA.

R

Thanks Rich,
I'll be watching out for them now. Anne