“My pain has disappeared and I can be a bigger part of my daughter’s life”

Sandhya took part in a research trial through the Virtual Biologics Clinic at CMFT - a service improvement implemented as part of the MAHSC IS4Ac course.
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After I gave birth to my daughter Rosa in 2012, I felt overcome by excruciating pain. I’m a busy person, a hard worker, but all of a sudden I couldn’t get out of bed, nevermind prepare my baby’s food. In 2013, I was diagnosed with rheumatoid arthritis. They tried two medicines – Methotrexate and Naproxen – but nothing really helped

I moved to Manchester and started at The Kellgren Centre at CMFT. I didn’t expect they could do much more than manage my pain and fatigue, but my consultant had higher hopes. She suggested I join a research trial they were running on a biologic therapy called Tocilizumab.

The change was incredible. The pain disappeared. I could play with Rosa and really enjoy and engage with this precious time of her life. I’ve even been able to volunteer part-time in the area I’m passionate about – women’s rights.

About the Virtual Biologics Clinic

Waiting times have been halved for rheumatoid arthritis patients prescribed biologic therapies and £100,000 is being saved every year at Manchester Royal Infirmary (MRI), following the introduction of the Virtual Biologics Clinic – a service improvement implemented as part of the MAHSC IS4Ac course.

Rheumatoid arthritis (RA) is a chronic disease which affects up to 1.5% of the population.  It is a significant health burden for patients, who can experience pain, reduced mobility and premature death unless they receive effective treatment.

The introduction of biologics has revolutionised the care of patients with RA, reducing these symptoms and longer-term risk of joint damage and disability. As such, these drugs are now a major component of modern-day treatment for the disease.

However, they are not the most suitable medication for all patients, who differ greatly in their needs, and they are significantly more costly than other treatments.

The Virtual Biologics Clinic at the Kellgren Centre for Rheumatology at Central Manchester University Hospitals NHS Foundation Trust was introduced in August 2013 to ensure that the prescription of biologic therapies was based primarily on the needs of patients and not on cost, to increase the speed at which patients gain access to the treatments, and provide more opportunities for patients to participate in clinical research so they may benefit from cutting-edge therapies and to improve the medical community’s knowledge of the disease.

Its aims are in line with the regional biologics pathway for RA, which was devised by the Greater Manchester rheumatology community in June 2013, and the aim of the National Institute for Health Research (NIHR) Manchester Musculoskeletal Biomedical Research Unit (BRU) to treat arthritis “right first time”.

Consultant Rheumatologist at the Kellgren Centre for Rheumatology and honorary senior lecturer at The University of Manchester, Dr Ben Parker, explains:

“It is a weekly hour-long clinic that brings together nurses, consultants and pharmacists to assess a patient’s needs.  As well as making the process more efficient for patients and the NHS, the Virtual Biologics Clinic supports our research.

“Every patient is assessed for possible research participation and if eligible is approached to discuss their potential involvement.  This is good for patients, because those offered the chance to participate in trials often have improved health outcomes and a better experience of healthcare.”

Professor Ian Bruce, Director of the NIHR Manchester Musculoskeletal BRU adds:

“Dr Parker and the team have had a real impact in using the best available evidence to drive up the quality of care we provide for our patients with RA. They have also achieved this whilst making real cost efficiencies and widening the access to clinical research in our centre”.

The Virtual Biologics Clinic was supported through the MAHSC Improvement Science for Academics (IS4Ac) course, delivered by Haelo, Salford’s innovation and improvement science centre, for MAHSC’s Population Health and Implementation Domain.

MAHSC Inflammation and repair domain - overview and biologics case study

MAHSC’s Inflammation and repair domain gives an overview of its work to improve the health of the Greater Manchester population and presents a case study of what academics and clinicians can achieve for patient care, working together, including information the groundbreaking work being carried out into biologics in Manchester.

Presented by Professor Jane Worthington, Academic lead for the Inflammation and repair domain; and Dr Kimme Hyrich, Reader and Honorary Consultant in Rheumatology at The University of Manchester and Central Manchester University Hospitals NHS Foundation Trust.


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