HoPES (Hope and Prepare Effectively for Surgery): Personalised self-management for managing hip and knee replacement wait lists

该项目通过开发和实施** hope ** （**Ho**和**P**有效地为** **手术准备** *E**）自我管理数字干预来解决健康老龄化挑战，使老年人在等待膝关节或髋关节手术时保持社会联系，更好地保持心理健康和身体活跃。该项目将支持Hope For The Community （H4C, Community Interest Company）的发展，扩大其客户基础，并推进与NHS作为关键市场合作的新路线。等候名单加长在肌肉骨骼医学（MSK）领域尤其是个问题。仅在英格兰，就有72.6万人患有严重的髋关节骨关节炎，140万人患有严重的膝关节骨关节炎。对于那些病情严重的人来说，关节置换手术是减轻疼痛、提高活动能力和自我管理能力的唯一选择。近4000名患者已经等待了两年多的手术。根据NHS章程，92%的患者应在18周内接受治疗，这是转诊治疗计划的一部分。在等待名单上，患者可能会经历更严重的疼痛，活动能力降低，焦虑增加和健康状况恶化，从而导致对健康和护理服务的更大需求。我们根据17名等待髋关节和膝关节置换术的患者（平均年龄71岁）和NHS西南地区5名服务领导的反馈，开发了一种概念验证的数字自我管理干预。在这个项目中，H4C与巴斯和东北萨默塞特、斯温顿和威尔特郡合作伙伴关系（BSW）、格洛斯特郡ICS和萨默塞特ICS以及考文垂大学合作，将开发一种结合循证自我管理内容和有效锻炼计划的新干预措施。锻炼部分是一个基于证据的家庭锻炼计划，参与者可以根据自己的需求和能力进行个性化的锻炼。在霍普斯干预成功验证后，我们将把它扩展到其他NHS信托基金，以获得最大的影响；对于正在等待或准备进行其他手术（例如癌症和心脏病）的其他患者，也有可能开发类似的干预措施。

This project addresses the Healthy Ageing Challenge by developing and implementing the **HoPES** (**Ho**pe and **P**repare **E**ffectively for **S**urgery) self-management digital intervention to keep older adults socially connected, in better mental health and physically active as they wait for knee or hip surgery.The project will support the growth of Hope For The Community (H4C, Community Interest Company) expanding its customer-base and advancing new routes to engage with the NHS as a key market.Lengthening waiting lists is particularly an issue in the area of Musculoskeletal medicine (MSK). In England alone, 726,000 people have severe hip osteoarthritis and 1.4 million people have severe knee osteoarthritis. For those whose condition is severe, joint replacement surgery is the only option to alleviate pain, and improve mobility and the ability to self-manage. Nearly 4,000 patients have been waiting for over 2 years for surgery. Under the NHS constitution, 92% of patients should be treated within 18 weeks as part of the referral-to-treatment scheme. While on the waiting list, patients are likely to experience worsening pain, reduced mobility, increased anxiety, and deteriorating health, leading to greater demand for health and care services.We have developed a proof-of-concept digital self-management intervention based on feedback from 17 patients (mean age 71 years) waiting for hip and knee joint replacement and 5 service leads in the NHS South West region.In this project, H4C working with Bath and North East Somerset, Swindon and Wiltshire Partnership (BSW), Gloucestershire ICS and Somerset ICS and Coventry University will develop a new intervention combining evidence-based self-management content and a validated exercise programme. The exercise component is an evidence-based home based exercise programme that participants can personalise to their needs and ability. After the HoPES intervention has been successfully validated, we will scale it to other NHS Trusts for the greatest impact; it will also be possible to develop similar interventions for other patients who are waiting/preparing for other surgeries (e.g. cancer and heart).