Osteoarthritis is a degenerative joint disease in which the tissues in the joint break down over time. It is the most common type of arthritis and is more prevalent in older people. Individuals with osteoarthritis typically experience joint pain and stiffness, especially after periods of rest or inactivity.
Pain and stiffness in a joint can significantly impact one's daily life, making it challenging to perform everyday tasks. For instance, individuals with leg pain may struggle with activities like climbing stairs or getting in and out of a car. Osteoarthritis in the hands can make it difficult to grip objects or perform fine motor tasks, such as buttoning clothes. However, many people with joint pain find ways to adapt and learn alternative methods for completing tasks.
Osteoarthritis has often been described as a "wear and tear" disease. In addition to cartilage breakdown, it affects the entire joint, causing changes in bone structure and the deterioration of connective tissues that hold the joint together and attach muscles to bones. It also leads to inflammation of the joint lining.
As soft tissue damage within the joint progresses, individuals may experience pain, swelling, and a reduction in joint mobility. Reduced activity due to joint pain can lead to muscle weakness, further stressing the affected joint. Over time, the joint may lose its normal shape, and small bone growths known as osteophytes or bone spurs may develop along the joint's edges. The shape of the bone may also change, and fragments of bone or cartilage can break off and float within the joint space, causing additional damage. Researchers are actively studying the causes of pain in individuals with osteoarthritis.
The overarching aim of JIGSAW-A is to improve the availability of evidence-based care for people with OA in Africa. As we know, for most people and for many health concerns, community Pharmacies are a popular first point of call for health advice. This is because community pharmacies are - informal, approachable, less clinical and accessible to many patients affected by Osteoarthritis
If we can strengthen networks and multi-professional team working between Doctors, Physiotherapists, and Community Pharmacists, patients may be better supported to self-manage better and live well regardless of joint pain.
In essence, the question we are asking ourselves is: How may we best empower patients with consistent, accessible information, and support community-pharmacies to work together with other professionals in primary-care settings to deliver high-quality, contextualized care for joint pain and Osteoarthritis?
JIGSAW-Africa is currently a pilot implementation study in Nigeria. We hope to be able to promote this initiative across Africa shortly. This flagship pilot project in Nigeria is comprised of four phases, and stakeholder engagement as well as patient and public involvement is being undertaken throughout the study:
Phase 1: Qualitative exploration of expressed needs
We have conducted focus groups with patients, community-pharmacists/pharmacy technicians, and physiotherapists/doctors to explore expressed support needs, uncertainties about medicines optimisation and evidence-based management for OA.
Phase 2: Co-design of JIGSAW-Africa resources to support Osteoarthritis and joint pain care
Stakeholder co-design workshops to produce contextualised, JIGSAW-A tools (informed by JIGSAW-E innovations: OA guidebook, training-package/consultation template) to support patient education, and community-based pharmacists to deliver integrated-OA care.
Phase 3: Pilot Implementation and Evaluation
JIGSAW-A feasibility study in eight/ten community-health settings/pharmacy retail outlets. This will be for 3 months after which we will be assessing JIGSAW-A tools usage, acceptability, and impact.
Phase 4: Wider JIGSAW-Africa implementation strategy
Involves further stakeholder work for develop recommendations for implementation based on findings and international expertise.
Expected Research outcome: JIGSAW-A tools including: