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New models of care for chronic musculoskeletal conditions

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New research from Curtin University and its partners provides guidance on how to address the rising burden of illnesses and disabilities associated with chronic non-communicable diseases, particularly musculoskeletal conditions.

The report, A Framework to Evaluate Musculoskeletal Models of Care, was prepared by Associate Professor Andrew Briggs and Associate Professor Helen Slater from Curtin University’s School of Physiotherapy and Exercise Science, and partner organisations.

The Framework aims to assist healthcare professionals, policy makers and health administrators develop, implement and evaluate their Models of Care (MoCs) for treating patients with musculoskeletal conditions.

“MoCs are used to inform best practice planning and delivery of health services. They are relevant across sectors and among policy makers, health administrators and managers, service delivery organisations, clinicians, researchers, funders, advocacy organisations and consumers,” Associate Professor Briggs said.

“With a focus on person-centred care in local settings, the aim of the Framework is to ensure MoCs can meet the current and future needs of people with musculoskeletal conditions.”

Associate Professor Briggs explained the disability burden associated with musculoskeletal conditions was enormous and exceeded most other chronic health conditions.

“In the most recent Global Burden of Disease Study, musculoskeletal conditions accounted for 23.3 per cent of global years lived with disability, which is a measure of disability burden.  It was second only to mental and substance use disorders, which was at 25.8 per cent of global years lived with disability,” he said.

“This highlights the need to address and improve MoCs for patients with these conditions.

“A major issue in musculoskeletal healthcare is that we have evidence for effective interventions but we lack evidence and guidance on how to implement that evidence into routine practice.”

Associate Professor Briggs explained the expectation over time is for patients to have improved experiences relating to access to services and information close to home; services that align with best evidence, especially in ambulatory care and community settings; and reduced inequalities when accessing care.

“While MoCs are not new, they are increasingly viewed as an effective strategy to improve health service planning and delivery. Despite the increased attention towards MoCs over the last 10 years, a globally-informed framework to evaluate an MoC’s readiness for implementation, and then its success, has been lacking until now,” he said.

“Readiness for implementation is really important. We’ve seen many positive programs initiated but these often fail to be sustainable in the longer term. These observations were the impetus for developing the Framework and its aim to optimise implementation sustainability.”

The Framework was developed using a rigorous research method and draws on the in-depth knowledge and experience of 93 international experts across 30 countries, and is publicly supported by 44 international organisations.

Research support was provided by the WA Department of Health, the NSW Agency for Clinical Innovation, NSW Health, HealthSense (Aust) Pty Ltd and BehaviourWorks Australia and is available here: http://bjdonline.org/assessing-the-readiness-of-models-of-care/.

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