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  Rheumatology 2004;43:1513–1518 doi:10.1093/rheumatology/keh371Advance Access publication 24 August 2004 Use of a corporate needs assessment to define theinformation requirements of an arthritis resourcecentre in Birmingham: comparison of patients’ andprofessionals’ views P. Adab, E. C. C. Rankin 2 , A. G. Witney 1 , K. A. Miles, S. Bowman 2 ,G. D. Kitas 4 , D. Situnayake 3 and P. A. Bacon 1 Objectives . Education and information are important components of the management of chronic disease, though provisionof these in the routine clinic setting may be suboptimal. We carried out a corporate needs assessment, both to evaluatestakeholders’ perceived usefulness of potential facilities that could be offered by a community-based arthritis resource centre inBirmingham and to compare the views of patients with rheumatological conditions and health professionals. Methods . Rheumatology patients ( n ¼ 201 responders/309 contacted) and health professionals ( n ¼ 232/430) were asked tocomplete a questionnaire to assess both current rheumatology service provision and perceived needs for further information thatcould be offered within the proposed resource centre. Views of patients and professionals were compared using odds ratios.Logistic regression analysis determined patient characteristics associated with perceived usefulness of various informationtypes. Results . The overall response rate was 58%. Most patients were currently receiving medication but only 38% received writteninformation on arthritis. Over 80% of responders felt that more information would be useful, particularly information inwritten leaflets. Compared with professionals, patients gave higher value to certain types of medical, non-medical, support andskills information, particularly individual information from trained volunteers, and specific information on benefits, diet andalternative therapy, and symptom management. Non-Caucasian patients gave higher value to the provision of material indifferent languages and the availability of multilingual volunteer staff. Conclusion . Rheumatology patients and professionals identified a relative lack of information for patients. There was wideinterest in the provision of more information, with value placed on the provision of material in different languages, at aneducational resource centre. This work has been used to develop the facilities currently offered at the Birmingham ArthritisResource Centre. Further research is needed to investigate the effectiveness of the provision of good quality information topatients with arthritis. K EY WORDS:  Arthritis, Needs assessment, Patient information, Resource centre.Rheumatic disease, with its associated costs, is the leading cause of disability in adults [1, 2] and is likely to become more importantover time as a result of predicted demographic changes [3]. It isassociated with a poor quality of life even compared with otherchronic diseases [4]. In rheumatology, there is evidence thateducation and self-management programmes can improve symp-toms and compliance with prescribed therapies, as well as reducinghealth service contact [5, 6]. In routine clinical practice, patients(including those with arthritis [7]) do not always receive theinformation they want and need [8, 9] and local experiencesuggests that provision of information may be particularly poorfor non-Caucasians. There is evidence that perspectives on infor-mation needs differ between patients and professionals [10, 11].Traditionally, information in the form of leaflets and other media(e.g. videos, audio tapes, computerized material and the internet)has been used to educate patients, particularly for self-care of chronic diseases such as arthritis. A wide range of interventions,providing information on a range of topics and delivered throughvarious media [12–14], has been shown to be effective for peoplewith arthritis.In order to address this issue in Birmingham, we decided to setup a community-based arthritis resource centre to provide infor-mation to people with arthritis and their carers outside the usualconfines of the National Health Service. The idea was modelled ona similar centre in Australia [15], though, as far as we know, thatcentre has not been evaluated. We carried out a needs assessmentin order to inform service provision. The intention was to use aformal assessment process to assess the views of interested partiesregarding such a service. Health needs assessment may be usedas an evidence-based approach to plan health services that willbe beneficial to the health of the population, within resourcelimitation [16, 17]. We describe a needs assessment using a Correspondence to: E. Rankin, Rheumatology, University Hospital Birmingham NHS Trust, Selly Oak, Birmingham B29 6JD, UK. Department of Public Health and Epidemiology and  1 Department of Rheumatology, University of Birmingham,  2 University Hospital Birmingham NHSTrust, Selly Oak, Birmingham,  3 City Hospital NHS Trust, Birmingham and  4 Dudley Group of Hospitals, Dudley, West Midlands, UK. Submitted 28 November 2003; revised version accepted 13 July 2004.Rheumatology Vol. 43 No. 12    British Society for Rheumatology 2004; all rights reserved 1513   a t  T r i  ni   t   y  C  ol  l   e g eL i   b r  ar  y  ,D  u b l  i  n on S  e p t   em b  er 1  5  ,2  0 1  0 r h  e um a t   ol   o g y . ox f   or  d  j   o ur n al   s . or  gD  ownl   o a d  e d f  r  om   corporate approach, which involves the systematic collection of theknowledge and views of local health professionals and users of health services on health-care services and needs [17]. The aim wasto assess the current provision of arthritis services; to discoverviews on perceived usefulness of potential types of informationthat the proposed arthritis resource centre could provide; and thento examine the preferences of patients with arthritis compared withprofessionals working with people with arthritis. In addition, weexamined variation among patients in their stated preferences forthe types of information to be provided. Methods Subjects and sampling methods During the period from August to October 2000, we undertook anexploratory cross-sectional study involving people with arthritisand a range of health professionals from primary and secondarycare. We used convenience sampling to identify patients withdiagnosed arthritis (new and follow-up) who were attendinggeneral rheumatology clinics at three hospitals in the WestMidlands. The aim was to obtain a minimum of 200 completedquestionnaires from patients. We obtained local research ethicscommittee approval for the patient questionnaires. Patients weregiven written information about the study, and, if they gaveconsent, were handed a self-administered questionnaire, availablein English only. However, given the ethnic diversity of the popu-lation in Birmingham, we asked patients about their perceivedimportance of offering information in different languages, eitherthrough information materials or through availability of multi-lingual volunteer staff in the centre. The questionnaire wascollected either before their consultation or sent in by post later.We were unable to follow-up non-responders, on advice from theethics committees (data confidentiality). A similar postal ques-tionnaire was sent to all general practices in Birmingham (as healthprofessionals dealing with arthritis, as well as representatives of patients in primary care), and to all rheumatology specialists,nurses, physiotherapists and occupational therapists in the WestMidlands. A reminder was sent to all professionals who had notresponded. A list of all general practitioners (GPs) in Birminghamwas obtained from the local health authority. Other professionalswere contacted from a list of specialist health-care workers inthe region. Development of the study instrument and outcome measures In order to prepare the questionnaire, semistructured interviewshad been held with 19 key stakeholders, such as communityleaders, GPs and arthritis support group members. The interviewscovered themes related to current information resources, perceivedgaps in provision, and the perceived usefulness of various resourcesthat a multicultural arthritis information centre might offer. Keycategories and concepts from the interviews and types of effectiveinterventions identified from the literature review were used todevelop the questionnaire. This was piloted among 50 patients andprofessionals to finalize the questionnaire.In thequestionnaire we askedparticipants to ratetheir perceivedusefulness of a range of information types (support information,non-medical health information, skills information and medicalinformation) potentially needed within the resource centre. Arange of information types identified through our review of theliterature was categorized in this way by consensus among theresearchers (Table 1). There was a point scale of 1–4, 1 being ‘not atall useful’ and 4 being ‘very useful’. Participants were also askedabout perceived usefulness of a range of services (e.g. informationthrough leaflets, audiotapes, videos and computers or via trainedvolunteers). They were encouraged to suggest other informationthat the centre could usefully provide, using an open-endedquestion. The questionnaire to GPs and patients also enquiredabout current service provision.In addition, patients were asked to give further demographicinformation (age, sex, level of education and ethnicity), theirmain rheumatological diagnosis, level of pain from arthritisand level of need for self-care. The last two were assessed usingsections of the Arthritis Impact Measurement Scale (AIMS 2)questionnaire [18] on self-care tasks and arthritis pain. Giventhe ethnic diversity of the population in Birmingham, we askedpatients about they perceived the importance of offering infor-mation in different languages, either through information mate-rials or through the availability of multilingual volunteer staff in the centre. Data analysis All data were entered and analysed using the Statistical Packagefor the Social Sciences (SPSS) statistical software, version 9.Descriptive analysis was used to describe the range of servicescurrently provided, and also the perceived usefulness of variousfacilities that the resource centre could offer. We described theproportion of patients and professionals who rated each serviceand information type as ‘very useful’ (rating of 4 on the scale).Views of these two groups of stakeholders were compared usingodds ratios (OR) and 95% confidence intervals (CI) for patientsperceiving a particular item as very useful compared withprofessionals.The range of information types was divided into four groups(Table 1). The perceived usefulness scale was also dichotomized,combining ratings 1 and 2 as ‘not useful’ and 3 and 4 as ‘useful’.Logistic regression analysis (using the enter method) was then usedto examine whether patient characteristics were related to the typeof information that was perceived to be useful. Each of the fourgroups of information type was used in turn in the logisticregression models. Patient characteristics included in the modelwere age, sex, level of education, ethnicity, level of arthritis pain,level of self-care and type of arthritis. T ABLE  1. Groupings used for type of information in logistic regressionmodelsType of information group Type of informationSupport information Entitlements to financial allowancesand benefitsAids and appliancesSupport groups and contactsNon-medical healthinformationDietRange and effects of alternative therapyBenefits and examples of exerciseSkills-related information Symptom management (e.g. pain control)Joint protectionDealing with emotions(fear, anger, depression)Self-management skills(problem-solving and decision-making)Medical information Common types of drugsCauses, presentation, treatment andprognosis of common problems suchas back painCauses, presentation, treatment andprognosis of rare rheumatologicalconditionsCommon side-effects of medication 1514  P. Adab  et al  .   a t  T r i  ni   t   y  C  ol  l   e g eL i   b r  ar  y  ,D  u b l  i  n on S  e p t   em b  er 1  5  ,2  0 1  0 r h  e um a t   ol   o g y . ox f   or  d  j   o ur n al   s . or  gD  ownl   o a d  e d f  r  om   Results Demographics The overall response rate was 58%, including 232 responses (54%)from health professionals and 201 (65%) from patients; in moredetail, GPs 36%, occupational therapists 56%, physiotherapists75%, rheumatology nurses 81% and rheumatologists 85%. Forpatients, 68% were female ( n ¼ 133) and the mean age was 51yr(range 18–87). Although the majority ( n ¼ 154) were Caucasian,19% were from minority ethnic groups. Approximately one-quarter ( n ¼ 52) of all patients were new referrals. The mostcommon types of arthritis were rheumatoid ( n ¼ 89), osteoarthritis( n ¼ 24) and a mixture of these ( n ¼ 9). Approximately a fifth of patients ( n ¼ 43) did not yet know their diagnosis and theremainder ( n ¼ 36) had other types of arthritis. Current services and information sources The types of service patients reported as having received werepredominantly medical, with 76% receiving medication. Just underhalf (49%) recalled having received verbal information on arthritisand their condition, and 38% stated they had been given writteninformation (data not shown).Within primary care, most GPs provide access to a rangeof services that are useful for people with arthritis; however,relatively few can do this within the practice setting. Forty-eightper cent provide written information and 25% provide alternativetherapies. Perceived usefulness of different types of information and range of services Taking all respondents combined, there was interest in all typesof information that the resource centre could offer. Over 80%felt that all the information specified would be useful. However,generally more responders perceived support-type and skills-typeinformation as useful compared with medical or lifestyle informa-tion. In terms of how information was provided, the most popularmethods were through written leaflets and trained volunteers,followed by videos and audiotapes. Participants were least keen oncomputerized information. There were few additional suggestionsto the open-ended questions, despite the offered scope for free text.The majority (>80%) of both patients and professionals ratedmost potential resources as useful (rating of 3 or 4). However, arating of ‘very useful’ (4) was more discriminating. Perceivedusefulness ranged from a low of 30% of professionals giving thisrating for information on rare rheumatological conditions, to ahigh of 79% of patients wanting to know about the side-effects of medication (Table 2).For almost all types of information, a significantly higherproportion of patients rated these as very useful compared withprofessionals (Table 2). The only exceptions were information onsupport groups and contacts, and information related to self-management skills, where fewer patients perceived these as useful.For certain types of information (entitlements, aids and appli-ances, symptom management and common side-effects of drugs),75% or more patients rated these as very useful. The greatestdiscrepancies between patients and professionals views (OR   2)were in relation to information on entitlements, diet, alternativetherapies, symptom management, joint protection techniques andall types of medical information. For the latter, about a thirdof professionals gave these a high rating, compared with overtwo-thirds of patients. Perceived usefulness of resources according to patient characteristics We examined patients’ responses in more detail. In general, olderpatients, men and those with a higher level of education were lesslikely to rate any information type as useful. Using logisticregression models with all patient characteristics included, youngerpatients and those with lower self-care scores were significantlymore likely to favour support information (Table 3). Women weresignificantly more likely to favour non-medical health information,and those with less education and more arthritis pain were sig-nificantly more likely to prefer skills-related information. Therewere no particular characteristics associated with the perceivedusefulness of medical information.There was generally low support for the centre providingmultilingual services, 12.8 and 10.7%, respectively, agreeing thatthe centre should provide volunteer staff or written material in T ABLE  2. Comparison of number (%) of patients and professionals who perceived information as ‘very useful’ (rating of 4 on a scale of 1–4)Type of information that could be offered by centreProfessionals PatientsOR (95% CI) forpatients  vs  professionals( n ) (%) ( n ) (%)Support informationEntitlements to financial allowances and benefits 113 (49.8) 125 (74.9) 3.00 (1.9–4.6)Aids and appliances 144 (62.9) 120 (75.5) 1.82 (1.2–2.8)Support groups and contacts 138 (60.3) 77 (50.3) 0.67 (0.4–1.0)Non-medical healthDiet 77 (33.8) 107 (66.5) 3.89 (2.5–6.0)Range and effects of alternative therapy 73 (32.0) 97 (63.4) 3.68 (2.4–5.7)Benefits and examples of exercise 133 (58.1) 98 (62.8) 1.22 (0.8–1.8)SkillsSymptom management (e.g. pain control) 133 (57.8) 118 (75.6) 2.27 (1.4–3.6)Joint protection 118 (51.8) 107 (68.2) 2.00 (1.3–3.0)Dealing with emotions (fear, anger, depression) 119 (51.7) 95 (62.1) 1.53 (1.0–2.3) Self-management skills (problem-solving and decision-making)  122 (54.0) 63 (42.0) 0.62 (0.4–0.9)Medical informationCommon side-effects of medication 88 (38.4) 125 (78.6) 5.89 (3.7–9.4)Causes, presentation, treatment and prognosisof common problems such as back pain96 (42.1) 106 (67.9) 2.91 (1.9–4.5)Causes, presentation, treatment and prognosisof rare rheumatological conditions69 (30.4) 101 (66.0) 4.45 (2.9–6.9)Common types of drugs 90 (39.6) 99 (64.3) 2.74 (1.8–4.2) Needs assessment for arthritis resource centre  1515   a t  T r i  ni   t   y  C  ol  l   e g eL i   b r  ar  y  ,D  u b l  i  n on S  e p t   em b  er 1  5  ,2  0 1  0 r h  e um a t   ol   o g y . ox f   or  d  j   o ur n al   s . or  gD  ownl   o a d  e d f  r  om   different languages. However, using a logistic regression modelthat included age, sex, level of education and ethnicity, we foundthat responders from minority ethnic groups were significantlymore likely to believe this was an important issue (Table 4). Therewas generally greater support for having multilingual volunteerstaff than for having written information in various languages. Discussion This paper is the first description, in the form of a needsassessment, of the views of rheumatology clinic patients andprofessionals from primary and secondary care on the informationand services that a community-based arthritis resource centre inBirmingham should provide. The results are thus a major stepforward in using the views of interested parties to provide a newservice that may empower people with arthritis and their carers.The aim of needs assessment is to gather the informationrequired to bring about change beneficial to the health of thepopulation, particularly in the context of scarce resources [17]. Thisapproach allows us to decide on interventions that will be of benefitto the population (needs) rather than focusing on what people ask(demands). A needs assessment includes a description of currentservices, identification of potentially beneficial interventions, andidentifying gaps in provision that health services could meet. Thereare different approaches to assessing health-care needs. Thecorporate approach used here involves eliciting the views of keystakeholders and is the most appropriate method for ensuringthat provision is sensitive to the local situation [17]. The rangeof information types and facilities we enquired about were thoseshown or suggested to be of benefit to people with arthritis, and wesought the views of stakeholders in prioritizing provision. Unlikea survey of ‘demands’ of stakeholders, corporate needs assessmentis not bound by majority views for decision-making, but ratherallows us to consider equity and effectiveness. For example,although the majority of participants here did not perceive theavailability of information in other languages to be important,those from minority ethnic groups did identify this as a priority.Furthermore, whilst many patients wanted information on dietand alternative therapies, lack of good evidence on the effective-ness of such interventions will inevitably limit the availabilityof such information at the centre. However, where interven-tions are effective and there are no issues around equity or costs,the views of stakeholders are an important consideration inprioritizing services.Questionnaire responses showed that current service provisiontends to ‘medicalize’ the treatment of patients with arthritis.Between a third and a half of the responders recalled receivinginformation, whereas three-quarters of the patients receivedmedication. It is likely that responder GPs were those with aninterest in rheumatology, and therefore current service provisionmay have been overestimated. Nevertheless, provision of informa-tion was perceived as of major importance and a gap in serviceprovision.While there was some agreement between patients and profes-sionals about the relative usefulness of different types of informa-tion, there were also some important differences. For example,there was a similar level of interest in the provision of informationon the benefits of exercise. However, patients were significantlykeener to have access to information on common side-effects of medication, rare rheumatological diseases, diet and alternativetherapy. The finding that not many patients rate self-managementskills as very useful is of concern, given that self-management isan effective intervention [6]. This idea merits further exploration:information alone may not make a difference to health-careoutcomes. Interestingly, patients gave a significantly higher ratingto the provision of almost all categories of information comparedwith professionals. Men were less likely than women to rate asimportant information on diet, alternative therapy and exercise.People from non-white ethnic groups rated as important materialin different languages and volunteers able to speak thoselanguages. The categories of information types (Tables 1 and 3) used inour study were derived through consensus among researchersfollowing review of the literature. The categories are thereforearbitrary and may differ from groupings selected by other researchers. There is potential for non-responder bias in the results frompatients and professionals. Responders included patients (new andfollow-up) and members of the multidisciplinary team. Althoughother studies have found ethnic minority populations to be under-represented in hospital outpatient clinics [19], it is interesting thatthe patient population studied here included 19% from ethnicminorities. Birmingham has approximately 22% of the populationfrom ethnic minorities. Unfortunately, we had neither interpretersnor resources to translate the questionnaire into other languagesfor patients who could not read English. An important limitationof this study is that it excluded patients from ethnic minoritieswho could not read English. T ABLE  3. Patient characteristics associated with perceived usefulness of various information typesSupport information Non-medical health information Skills information Medical informationOR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)Increasing age 0.96 (0.93–0.99) 0.98 (0.95–1.01) 0.99 (0.96–1.01) 1.00 (0.97–1.03)Male (compared with female) 0.73 (0.28–1.89) 0.34 (0.14–0.81) 0.82 (0.31–2.17) 0.54 (0.20–1.47)Lower level of education 2.01 (0.72–5.61) 1.79 (0.66–4.91) 2.78 (1.02–7.57) 2.07 (0.73–5.91)White ethnicity (compared withother ethnic group)1.89 (0.62–5.77) 0.78 (0.23–2.58) 1.34 (0.40–4.54) 2.13 (0.62–7.40)Increasing score for arthritis pain 1.01 (0.82–1.23) 1.16 (0.96–1.40) 1.20 (0.99–1.46) 1.01 (0.82–1.25)Reducing score for self-care 1.25 (0.99–1.58) 1.05 (0.86–1.29) 0.89 (0.72–1.09) 0.94 (0.76–1.18)Rheumatoid arthritis (comparedwith other form of arthritis)0.69 (0.27–1.79) 0.49 (0.20–1.23) 1.48 (0.54–4.03) 1.62 (0.55–4.78)T ABLE  4. Logistic regression model: factors associated with perceivedimportance of multilingual provisionProviding materialin different languagesProviding multilingualvolunteer staff OR (95% CI) OR (95% CI)Other ethnicity(compared with white)4.78 (1.22–18.73) 3.72 (0.98–14.07)Male (comparedwith female)0.87 (0.21–3.70) 3.85 (1.10–12.50)Increasing age 1.02 (0.97–1.06) 1.02 (0.98–1.06)Lower level of education2.38 (0.46–12.5) 1.61 (0.39–6.67) 1516  P. Adab  et al  .   a t  T r i  ni   t   y  C  ol  l   e g eL i   b r  ar  y  ,D  u b l  i  n on S  e p t   em b  er 1  5  ,2  0 1  0 r h  e um a t   ol   o g y . ox f   or  d  j   o ur n al   s . or  gD  ownl   o a d  e d f  r  om   The limited response rate could mean that we have over-estimated the level of interest in information provision and itsperceived usefulness. However, we obtained a range of views.Patients and professionals were prompted to consider varioustypes of information. This could have limited the scope forrespondents to come up with other unmet needs. However, thequestions were derived from the initial qualitative study plus areview of the literature, so should have covered most relevantaspects. It could be argued that such a comprehensive question-naire leads to positive replies because responders are unlikely tosay no to the provision of more information. This argument is tosome extent reflected in the results, but nevertheless respondersexpressed priorities in information and service provision. Thus,this is not simply a rheumatologist’s wish-list but represents thepriorities of a wider range of stakeholders. Recently, there has beena greater emphasis on the involvement of patients in the planningof health services and greater debate on priority setting [20, 21].When this is done, there is a demand for high-quality information,as this needs assessment shows.Neville  et al  . [10] developed a questionnaire in which they askedthe perceived needs of rheumatology clinic patients (hospital andprivate practice) in Canada. Their questionnaire was developedwith the help of patients, professionals and a review of theliterature. Patients were grouped according to diagnosis. Over 90%of respondents were interested in learning about their diseaseand its treatment, and there was least interest in self-managementcourses and self-help groups. Similarly, our responders (patientsand professionals) rated information on almost all aspects of arthritis and care above information on self-management. Likeours, their respondents preferred information in written format.Comparisons of the preferences of physicians and arthritispatients have shown that patients rank continuity of care morehighly than do physicians, and that there is a desire for moreinformation, particularly on diet and exercise [22, 23]. However,these studies did not include primary care physicians or othermembers of the multidisciplinary team, and they referred to thehospital setting.The Birmingham Arthritis Resource Centre (BARC), which hasbeen set up on the basis of these findings, aims to provide high-quality information in an appropriate form to people (patientsand carers) in their own language. The resource centre aimsto complement standard medical care for people with arthritis,providing information at a convenient city-centre location, withlong opening hours and minimal waiting without an appointment.We hope to encourage self-care and to help people to identifywhether they should consult a doctor. Our aims are similar to theNHS walk-in centres that have been established in England.Interestingly, the number of people attending these centres isincreasing and includes a higher proportion of younger adults thantypically consult their GP [24]. In one area, the introduction of anNHS walk-in centre did not affect the workload of local GPs,though continuing assessment will be needed to assess the impacton local NHS providers [25, 26].Information must be comprehensive andrelevant, and presentedin a format that is acceptable and useful. A key part of thedevelopment of such resources is the involvement of patients andclinicians. An attempt to collect and disseminate such resourcesfrom one centre to a wider audience has been tried in Australia [15].However, that centre has not been evaluated and it is unknownwhether the needs of people with arthritis were met.The needs assessment described here has guided prioritizationof the range and type of information that BARC is planning toprovide. BARC was opened in April 2001 and provides a rangeof information predominantly in written format. Multilingualvolunteer staff provide clients with information.The aims of BARC are directly in line with a recent governmentinitiative ‘Tackling Health Inequalities—A Programme for Action’[27]. We are attempting to address the inequalities in Birmingham,particularly between differentethnic communities. Our centre musthave ongoing evaluation of its impact. This research is beingundertaken in association with health psychologists and educa-tionalists. Thus, the future development of BARC will be based onassessment of its effectiveness in an iterative process which shouldpromote client satisfaction. Acknowledgements The authors would like to thank Professor K. K. Cheng,Professor of Epidemiology, Department of Public Health andEpidemiology, University of Birmingham, for his advice on thisproject. We would also like to thank the Arthritis ResearchCampaign for financial support in the form of a Special PurposeGrant, and Birmingham City Council and staff at the CentralLibrary for providing facilities and support for our staff andvolunteers. We are grateful to Mrs Chan Gordhan, Managerof the Birmingham Arthritis Resource Centre, Miss Mary Hall,the previous manager, and all the volunteer staff. Pharmaciaprovided an unrestricted educational grant.The authors have declared no conflicts of interest. References 1. Martin J, Meltzer H, Elliot D. The prevalence of disability amongadults. HMSO–OPCS survey of disability in GB. London: HMSO,1988.2. Yelin E, Callahan LF. The economic cost and social and psycho-logical impact of musculoskeletal conditions. Arthritis Rheum1995;38:1351–62.3. Oeppen J, Vaupel JW. Demography. Broken limits to life expectancy.Science 2002;296:1029–31.4. Sprangers MAG, de Regt EB, Andries F  et al  . Which chronicconditions are associated with better or poorer quality of life? J ClinEpidemiol 2000;53:895–907.5. Hirano PC, Laurent DD, Lsrc K. Arthritis patient education studies,1987–1991: a review of the literature. Patient Educ Couns 1994;24:9–54.6. Kruger JM, Helmick CG, Callahan LF, Haddix AC. Cost-effectiveness of the arthritis self-help course. Arch Intern Med 1998;158:1245–9.7. Maddox J. Medical care and the arthritis sufferer: a survey in outerMelbourne. Aust Fam Physician 1982;10:876–82.8. Audit Commission. What seems to be the matter: communicationbetween hospitals and patients. London: HMSO, 1993.9. Coulter A. Evidence based patient information. Br Med J 1998;317:225–6.10. Neville C, Fortin PR, Fitzcharles M-A  et al  . The needs of patientswith arthritis: the patient’s perspective. Arthritis Care Res 1999;12:85–95.      R     h   e   u   m   a    t   o     l   o   g   y Key messages   A corporate needs assessment is a usefulmethod for developing a communitybased resource centre for people witharthritis and their carers.   Current service provision for peoplewith arthritis is ‘medicalized’, yet mostpatients value a wide range of informa-tion types.   Interesting differences in the prioritiesfor information between patients andprofessionals are shown.Needs assessment for arthritis resource centre  1517   a t  T r i  ni   t   y  C  ol  l   e g eL i   b r  ar  y  ,D  u b l  i  n on S  e p t   em b  er 1  5  ,2  0 1  0 r h  e um a t   ol   o g y . ox f   or  d  j   o ur n al   s . or  gD  ownl   o a d  e d f  r  om 
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