01 March 2021
This month's blended learning programme focuses on psoriatic arthritis (PsA). Here we talk to Dr Will Tillett, a consultant rheumatologist in Bath and Senior Lecturer in Pharmacy and Pharmacology. Will has a research interest in psoriatic arthritis and is the co-chair of BSR's PsA guidelines update group. He's also the co-chair of the PsA OMERACT group and a member of GRAPPA.
How did you become interested in PsA?
I was interested fairly early on during my specialist training and did my PhD looking at work disability and patient-centred outcome in psoriatic arthritis, working with Prof Neil McHugh in Bath.
Tell us about your career path and research interests
After specialty training in rheumatology, I was appointed as a consultant in 2014. I spend three days a week working as an NHS consultant, leading our biologics service. I spend my other two days doing clinical research.
The overarching aim of my research is to improve the lives of people living with arthritis through improved detection, assessment (patient-reported, clinical and imaging) and treatment strategies. It’s impossible to do this without involving patients, who are involved in designing, conducting and reporting all my studies.
I’m really keen to make sure that guidelines and research are easy to translate into everyday clinical practice and this paper sets out how the guidelines will do that. Also, one of the challenges we have in the treatment of PsA is the assessment area- we don’t have agreement yet on how to measure the disease in our time pressured routine clinics.
There's some exciting work on this coming out over the next few months (perhaps not in time for the updated guideline) but we should have a pragmatic way to assess disease activity that captures all relevant domains and is easy to complete.
Tell us about your work with our guidelines group
I was approached when I was working as a fellow and invited to join, as the team were aware of my interests. The current group is quite large and includes dermatologists, rheumatologists, allied healthcare professionals and other stakeholders. There's also a methodologist funded by BSR, who ensures the literature searches and evidence we use are of high quality and current; they've been invaluable.
Tell us about the new PsA guideline
We're aiming to launch it in autumn 2021. It’s a big piece of work and we need to get it right so it can be comprehensive but accessible for use in daily practice.
Quite a lot's changed since the previous guideline was written, including the development of new medications and treatment strategies. The new guideline updates on this, covering a range of key topics including novel drug therapy, treat-to-target, biologic tapering and the role of smoking and body mass index. It informs users of the level of evidence and agreement for different recommendations and identifies gaps and next steps.
What would you like it to achieve?
We hope to produce a guideline which allows practising clinicians to implement best practice at the cutting edge of new evidence and real-world experience. We aim to challenge clinicians to follow best practice for all their patients and think holistically about their management and wellbeing. We'll align with other relevant guidelines e.g. BSR DMARDs in pregnancy and current best practice.
Any tips for people who might be interested in developing a special interest and getting involved in projects like guidelines?
Make the most out of opportunities along the way. There are lots of great out-of-programme experiences which don’t have to result in a PhD, although who knows where they might lead. Start small by attending dedicated clinics in an area that you're interested in, and then test the water with a small research project.
Also, find someone you'd like to work with and ask them for help. Get involved by joining research and awareness organisations such as BRITPACT and GRAPPA and come to meetings of BSR's PsA special interest group.
What’s your message to members?
PsA is a really interesting area to work in: I'm accepting students who'd like to undertake research projects of any duration up to and including PhD studies. Please get in touch if you'd like to get involved in a project or have a research idea. If I can’t help you I will try and find someone who can. Email me for more.