260 Globalisation of Paediatric Musculoskeletal Matters (PMM)

Background: Paediatric musculoskeletal matters (PMM-www.pmmonline.org) is a free, evidence-based and peer reviewed open e-resource for paediatric musculoskeletal (MSK) medicine targeting non-MSK specialists. Since launch (Nov-2014) PMM has reached 190 countries with >78,000 users, >244,500 hits. Users who have declared their training background on the website are mainly non-MSK specialists. Feedback from users has requested further content to reflect international healthcare systems. PMM India was developed in collaboration with the Indian Academy of Paediatrics (IAP; Sept-2015, >3,700 users, 16,000 hits to date) and showcases successful partnership with local clinicians in developing PMM with local context. Further ‘internationalisation’ is now ongoing with additional global partners to develop PMM International. Here, we describe the process for international development. Methods: Paediatric rheumatologists in 11 countries around the world were approached to peer-review and identify additional PMM content to reflect paediatric MSK medicine in their health care systems (e.g., case mix, clinical presentations, care pathways), with a focus on knowledge relevant for non-MSK specialists. New content was developed by local teams identified by the paediatric rheumatologist(s) who then collated and provided expert overview before submission for editorial review. All contributions were provided in English. Additional cases and images were included with appropriate consent. Results: PMM International additions to the original website brings new content predominately focused on infections/infection-related disease with MSK features or as differential diagnoses for rheumatic disease. Most content is in English with requests for translation of some content (e.g., pGALS which is available in 11 languages to date). PMM International will be further peer reviewed with open access to all. A PMM app is planned to facilitate access where internet capacity is limited. Conclusion: Rapid globalisation necessitates appropriate e-resources with content that reflect international health care contexts. PMM International targets non-MSK specialist audiences to raise awareness and early recognition of MSK pathology. Our work reflects strong collaborative global partnerships within the paediatric rheumatology community. PMM has been endorsed by the Paediatric Rheumatology European Association (PReS) as an educational resource. Implementation of PMM International has yet to be formally evaluated (i.e., change in knowledge, practice), but data thus far supports wide reach and positive uptake from the target audience user groups.