Development of the effective musculoskeletal consumer scale.

Programs and initiatives have been created to empower, educate, and provide information to consumers; these are sometimes generically known as self-management interventions. Evaluating and comparing such programs has been a challenge, as many skills that consumers believe are important to manage and participate in their individual healthcare are not currently captured by existing tools. The objective of the Effective Musculoskeletal Consumer Project is to develop a scale to measure an effective consumer. A review of the literature, interviews, workshops, and preliminary surveys at OMERACT 7 (May 2005) were conducted in the first phases of the Project. A questionnaire consisting of 64 items was developed to measure the skills and attributes of an effective musculoskeletal (MSK) consumer. Content experts on our team reduced this scale to 48 items, which was pilot-tested with consumers from Canada and Australia. Dimensionality assessment showed that the scale was unidimensional. Classical and item response theory analyses showed that the 48-item scale had quite high reliability, but that 2 items were very poor. Based on the item analysis, 35 items were retained. The revised scale was presented at OMERACT 8, where a panel reviewed the scale and provided input. This input and another expert review by our team was used to further refine the Effective Consumer Scale to 17 items. Plans are now under way to validate this 17-item scale in self-management interventions.

Consumer-driven health care: building partnerships in research.

Over the past four decades, there has been a widespread movement to increase the involvement of patients and the public in health care. Strategies to effectively foster consumer participation are occurring within all research activities from research priority setting to utilization. One of the ten principles of the Cochrane Collaboration is to 'enable wide participation', and this includes consumers. The Cochrane Musculoskeletal Group (CMSG) is a review group of 50 within the Collaboration that has been working to increase consumer participation since its inception in 1993. Based in Canada, the CMSG has embraced the concept of knowledge translation as advocated by the Canadian Institutes of Health Research. The emphasis in knowledge translation is on interactions or partnerships between researchers and users to facilitate the use of relevant research in decision making. While the CMSG recognizes the importance of reaching all users, much of its work has focused on developing relationships with people with musculoskeletal diseases to enhance consumer participation in research. The CMSG has built a network of consumer members who guide research priorities, peer review systematic reviews and also promote and facilitate consumer-appropriate knowledge dissemination. Consumers were recruited through links with other arthritis organizations and the recruitment continues. Specific roles were established for the consumer team and responsibilities of the CMSG staff developed. The continuing development of a diversified team of consumer participants enables the CMSG to produce and promote access to high quality relevant systematic reviews and summaries of those reviews to the consumer.

Attributes and skills of an effective musculoskeletal consumer.

The OMERACT 7 Effective Musculoskeletal Consumer Workshop brought together people with rheumatoid arthritis, healthcare professionals, and researchers to discuss what they thought made a musculoskeletal consumer effective at managing their disease. Preliminary work before OMERACT provided a draft list of potential characteristics of an effective consumer. Participants at the workshop provided feedback about the list including relevance, missing items, format, and language. The feedback provided was useful and will be incorporated into a revised list to aid in the development of an instrument to measure health consumer effectiveness.