Supporting people with musculoskeletal disorders in Scotland to remain in work: adapting the Making it Work™ intervention developed for people with inflammatory arthritis in Canada

​​​​​​One in three adults in Scotland are affected by a musculoskeletal condition, and these conditions have a substantial impact on individuals' lives including their work participation. They impact on individuals' 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 .

We aimed to adapt the Making it Work™ programme so that it is relevant for people working with a larger range of musculoskeletal conditions, and to make its delivery suitable for the Scottish health and social care context. We expanded the programme to people with fibromyalgia, osteoarthritis, and chronic regional and widespread pain which represent common and disabling non-inflammatory musculoskeletal conditions in Scotland.

The research consisted of three distinct stages, or workpackages. Within these workpackages, the aims of the study were to:

• Explore ideas with patients and other key stakeholders about how to develop or adapt the programme so that it is relevant for people with non-inflammatory conditions who are working in Scotland;
• Identify which aspects of the current programme are specific to inflammatory conditions only, specific to the Canadian health and social care context, and / or specific to a work context which does not necessarily generalise to a post-COVID working world;
• Understand possible referral pathways to the programme, which 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
• Make changes to the content and/or delivery of the programme based on findings from the above;
• And finally, assess the acceptability, relevance, and usability of the modified programme with patients with inflammatory and non-inflammatory musculoskeletal conditions who are working in Scotland.

​​​Across the study's main stages we recruited across a number of different groups, including patients with inflammatory or non-inflammatory musculoskeletal conditions, employers across small-, medium- and large-enterprises, and a range of healthcare professionals. For our final user-testing phase we engaged with people with musculoskeletal conditions working in a variety of work settings to get their views on the adapted programme.

The Making it Work™ programme has been successful in Canada in supporting people with inflammatory arthritis to stay in work for as long as they wish to. This not only has obvious economic benefits for society, but participation in working life is also known to have many personal and social benefits for individuals. This study has helped us to tailor this programme to the UK context, both for those working with inflammatory and non-inflammatory musculoskeletal conditions.

Summary report to funders

During a recent visit to the Epidemiology Group premises at Foresterhill Campus, we were delighted to present our latest research findings to one of our key funding partners, Versus Arthritis . As part of these presentations, we produced a poster summarising the work we have done so far redeveloping the Making it Work™ programme.

You can view and download the poster below:

• Ghiglieri, Anderson, Wainwright, Hollick, Lacaille, Macfarlane and Morton, Making it Work™ - Scotland: Adapting a Canadian programme to support people working with musculoskeletal (MSK) conditions in the UK
  
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We have now completed all research and testing phases of this project. We hope to make the programme available to the public sometime in early 2025.

If you would like to know more about the study, have any questions, or would like to be notified when the programme becomes available, please email the study team at makingitwork@abdn.ac.uk .

The following team will be responsible for delivering the study:

• Professor Gary Macfarlane - Chief investigator
• Dr LaKrista Morton - Co-chief investigator
• Dr Rosemary Hollick - Co-investigator
• Dr Elaine Wainwright - Co-investigator
• Dr Diane Lacaille (Arthritis Research Canada) - Co-investigator
• Professor Karen Walker-Bone (University of Southampton) - Co-investigator
• Dr Cara Ghiglieri - Research Fellow
• Stuart Anderson - Project coordinator

This study has been funded by Chief Scientist Office .

• Tel: 01224 437863
• Email: makingitwork@abdn.ac.uk