Global health policy in the 21st century: Challenges and opportunities to arrest the global disability burden from musculoskeletal health conditions

Briggs, Andrew M.; Shiffman, Jeremy; Shawar, Yusra Ribhi; Åkesson, Kristina; Ali, Nuzhat; Woolf, Anthony D.

doi:10.1016/j.berh.2020.101549

Cited by 58 publications

(41 citation statements)

References 100 publications

(186 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This significant and escalating burden raises the question: why is MSK health not prioritised within global or national health system strengthening efforts commensurate with its burden of disease [3,[28][29][30][31][32]? This lack of prioritisation highlights a lost opportunity to positively impact the global burden of disability [33]. 'Calls to Action' for global responses to the health and economic burden attributed to MSK conditions have been made for some time, preceding, during and following the Bone and Joint Decade 2000-2010 [34], with the need for global action on MSK health a key finding from GBD 2019 [4].…”

Section: Introductionmentioning

confidence: 99%

“…'Calls to Action' for global responses to the health and economic burden attributed to MSK conditions have been made for some time, preceding, during and following the Bone and Joint Decade 2000-2010 [34], with the need for global action on MSK health a key finding from GBD 2019 [4]. While much progress was achieved through the Decade through raising awareness about MSK disease burden, sustained and systematic health system strengthening responses are lacking and disability continues to rise [33]. Most calls have focused on 'what' needs to be done [18,31,32,[35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The need for adaptable global guidance in health systems strengthening for musculoskeletal health: a qualitative study of international key informants

Briggs

Jordan²,

Kopansky-Giles

et al. 2021

glob health res policy

Self Cite

View full text Add to dashboard Cite

Background Musculoskeletal (MSK) conditions, MSK pain and MSK injury/trauma are the largest contributors to the global burden of disability, yet global guidance to arrest the rising disability burden is lacking. We aimed to explore contemporary context, challenges and opportunities at a global level and relevant to health systems strengthening for MSK health, as identified by international key informants (KIs) to inform a global MSK health strategic response. Methods An in-depth qualitative study was undertaken with international KIs, purposively sampled across high-income and low and middle-income countries (LMICs). KIs identified as representatives of peak global and international organisations (clinical/professional, advocacy, national government and the World Health Organization), thought leaders, and people with lived experience in advocacy roles. Verbatim transcripts of individual semi-structured interviews were analysed inductively using a grounded theory method. Data were organised into categories describing 1) contemporary context; 2) goals; 3) guiding principles; 4) accelerators for action; and 5) strategic priority areas (pillars), to build a data-driven logic model. Here, we report on categories 1–4 of the logic model. Results Thirty-one KIs from 20 countries (40% LMICs) affiliated with 25 organisations participated. Six themes described contemporary context (category 1): 1) MSK health is afforded relatively lower priority status compared with other health conditions and is poorly legitimised; 2) improving MSK health is more than just healthcare; 3) global guidance for country-level system strengthening is needed; 4) impact of COVID-19 on MSK health; 5) multiple inequities associated with MSK health; and 6) complexity in health service delivery for MSK health. Five guiding principles (category 3) focussed on adaptability; inclusiveness through co-design; prevention and reducing disability; a lifecourse approach; and equity and value-based care. Goals (category 2) and seven accelerators for action (category 4) were also derived. Conclusion KIs strongly supported the creation of an adaptable global strategy to catalyse and steward country-level health systems strengthening responses for MSK health. The data-driven logic model provides a blueprint for global agencies and countries to initiate appropriate whole-of-health system reforms to improve population-level prevention and management of MSK health. Contextual considerations about MSK health and accelerators for action should be considered in reform activities.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The need for adaptable global guidance in health systems strengthening for musculoskeletal health: a qualitative study of international key informants

Briggs

Jordan²,

Kopansky-Giles

et al. 2021

glob health res policy

Self Cite

View full text Add to dashboard Cite

show abstract

“…Chronic or persistent, non-cancer pain is a pervasive public health problem 1 and a leading cause of disability worldwide. 2 3 Persistent pain is one of the most common health conditions in New Zealand (NZ), affecting more than 20% of adult New Zealanders. 4 The increase in persistent pain is partly attributable to the fast growing, ageing population in NZ.…”

Section: Introductionmentioning

confidence: 99%

“…8 The total cost to the NZ economy of all persistent pain conditions is estimated to be $14.8 billion (in 2016) that should project to $24 billion by 2048. 9 Recognising the escalating socioeconomic burden of persistent pain conditions, 2 3 global efforts have been advocating for integrated health policy and system changes. 10 …”

Section: Introductionmentioning

confidence: 99%

Clinical and cost-effectiveness of an online-delivered group-based pain management programme in improving pain-related disability for people with persistent pain—protocol for a non-inferiority randomised controlled trial (iSelf-help trial)

Hale¹,

Devan²,

Davies³

et al. 2021

BMJ Open

View full text Add to dashboard Cite

IntroductionPersistent non-cancer pain affects one in five adults and is more common in Māori—the Indigenous population of New Zealand (NZ), adults over 65 years, and people living in areas of high deprivation. Despite the evidence supporting multidisciplinary pain management programmes (PMPs), access to PMPs is poor due to long waiting lists. Although online-delivered PMPs enhance access, none have been codesigned with patients or compared with group-based, in-person PMPs. This non-inferiority trial aims to evaluate the clinical and cost-effectiveness of a cocreated, culturally appropriate, online-delivered PMP (iSelf-help) compared with in-person PMP in reducing pain-related disability.Methods and analysisMixed-methods, using a modified participatory action research (PAR) framework, involving three phases. Phase I involved cocreation and cultural appropriateness of iSelf-help by PAR team members. Phase II: The proposed iSelf-help trial is a pragmatic, multicentred, assessor-blinded, two-arm, parallel group, non-inferiority randomised controlled trial. Adults (n=180, age ≥18 years) with persistent non-cancer pain eligible for a PMP will be recruited and block randomised (with equal probabilities) to intervention (iSelf-help) and control groups (in-person PMP). The iSelf-help participants will participate in two 60-minute video-conferencing sessions weekly for 12 weeks with access to cocreated resources via smartphone application and a password-protected website. The control participants will receive group-based, in-person delivered PMP. Primary outcome is pain-related disability assessed via modified Roland Morris Disability Questionnaire at 6 months post intervention. Secondary outcomes include anxiety, depression, stress, pain severity, quality of life, acceptance, self-efficacy, catastrophising and fear avoidance. Data will be collected at baseline, after the 12-week intervention, and at 3 and 6 months post intervention. We will conduct economic analyses and mixed-method process evaluations (Phase IIA).Ethics and disseminationThe Health and Disability Ethics Committee approved the study protocol (HDEC18/CEN/162). Phase III involves dissemination of findings guided by the PAR team as outcomes become apparent.Trial registration numberACTRN 12619000771156.

show abstract

“…It is unequivocal that common musculoskeletal pain conditions such as back, neck, and joint pain are the leading causes of worldwide disability burden. 2 Physical rehabilitation has always played a valuable role in the treatment of people with musculoskeletal pain. Yet, physical rehabilitation approaches, for example, exercise, have often played second fiddle to pharmacological and psychological treatments.…”

mentioning

confidence: 99%

Introduction to special issue on new directions in physical rehabilitation of musculoskeletal pain conditions

Sterling¹

2020

PR9

View full text Add to dashboard Cite

Global health policy in the 21st century: Challenges and opportunities to arrest the global disability burden from musculoskeletal health conditions

Cited by 58 publications

References 100 publications

The need for adaptable global guidance in health systems strengthening for musculoskeletal health: a qualitative study of international key informants

The need for adaptable global guidance in health systems strengthening for musculoskeletal health: a qualitative study of international key informants

Clinical and cost-effectiveness of an online-delivered group-based pain management programme in improving pain-related disability for people with persistent pain—protocol for a non-inferiority randomised controlled trial (iSelf-help trial)

Introduction to special issue on new directions in physical rehabilitation of musculoskeletal pain conditions

Contact Info

Product

Resources

About