Moving from evidence to practice: Models of care for the prevention and management of musculoskeletal conditions

Speerin, Robyn; Slater, Helen; Li, Linda; Moore, K.Ford; Chan, Madelynn; Dreinhöfer, Karsten; Ebeling, Peter R.; Willcock, Simon; Briggs, Andrew M.

doi:10.1016/j.berh.2014.07.001

Cited by 102 publications

(107 citation statements)

References 137 publications

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“…17,18 Evaluation by an interprofessional chronic pain team leads to a tailored comprehensive pain management plan for children and adolescents, which encourages improved function, promotes self-management, and ultimately results in less reliance on multiple health providers and health care cost reduction. [18][19][20][21][22][23] The Ontario Ministry of Health and Long Term Care (MOHLTC) established a Pediatric Chronic Pain Network to address this important health issue, one of the objectives of which was to improve access to interprofessional pediatric chronic pain clinics in Ontario. 24 One of the overarching mandates of the network is to evaluate the impact of attendance at interprofessional pediatric chronic pain clinics on health care utilization.…”

Section: Introductionmentioning

confidence: 99%

The association between pediatric chronic pain clinic attendance and health care utilization: A retrospective analysis

Campbell

Stinson

Ouellette

et al. 2018

Canadian Journal of Pain

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Background: Pediatric chronic pain is common, disabling, and costly. Children with chronic pain have high health care utilization in that they are seen by multiple health care providers, have frequent emergency room visits, and require many diagnostic tests. Pediatric health care utilization relating to direct health care services and associated costs of attendance at chronic pain clinics in Canada has not been well described. Aim: The purpose of this project was to analyze the cost of physician services for individuals attending an interprofessional pediatric chronic pain clinic over an 8-year span including years before, during, and after treatment. Methods: Physician claims were extracted from the Ontario Health Insurance Plan (OHIP) Claims History Database and retrospectively reviewed over 8 fiscal years for 100 new patients seen at the Chronic Pain Clinic at the Hospital for Sick Children. The utilization metrics analyzed included physician consultations and follow-up appointments, emergency room visits, lab tests, and diagnostic imaging. These data reflected 2 years prior to the first chronic pain clinic appointment, year of initial appointment, and five subsequent years. Results: Health care utilization based on OHIP claims related to physician services and cost analysis showed an increase during the 2 years prior to first chronic pain clinic appointment, a decrease during the year of initial appointment, and a further decrease over the subsequent 5 years. Conclusions: Further prospective research is required to establish whether attendance at the chronic pain clinic caused the reduction in health care services and costs and, if so, to identify the effective components of treatment.

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Section: Introductionmentioning

confidence: 99%

The association between pediatric chronic pain clinic attendance and health care utilization: A retrospective analysis

Campbell

Stinson

Ouellette

et al. 2018

Canadian Journal of Pain

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“…A contemporary approach to the management of PMP adopts a person-centred model of engagement and management where the unique set of factors driving the pain experience are addressed with specific multimodal interventions, provided in an appropriate sequence and volume for the person 19 65. A one size fits all model based on unimodal interventions is not appropriate; this is consistent with findings in returning people to work after absence, where successful reintegration is facilitated by using a multifaceted approach 66.…”

Section: Discussionmentioning

confidence: 92%

“…Interventions can be targeted at a range of levels: individual, environmental or organisational; focusing on a particular level or taking a multilevel approach 18. Accommodations that address the multidimensional aspects of productivity in workers with PMP may be more effective than those that take a more narrow focus; synchronous to a biopsychosocial approach to managing PMP 19. This review sought to investigate this issue.…”

Section: Introductionmentioning

confidence: 99%

Persistent musculoskeletal pain and productive employment; a systematic review of interventions

et al. 2016

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A systematic analysis of the literature was undertaken to determine which characteristics of workplace interventions are most effective in assisting people with persistent musculoskeletal pain (PMP) to remain productively employed. Databases of Medline, PsychINFO, CINAHL and Embase were searched using MeSH and other relevant terms. Studies that reported on interventions at, or involving, the workplace were included. Interventions were considered as either focused on the individual or multilevel. Outcome measures assessed included: job loss, productivity, sick leave, pain and cost benefit. A quality assessment was undertaken using GRADE criteria with development of impact statements to synthesise the results. Eighteen relevant articles (14 studies) were identified for inclusion in the review. No high-level evidence for workplace interventions to assist people with PMP were identified. Low numbers of participants and limited studies resulted in downgrading of evidence. However, individually focused interventions will probably reduce job loss and sick leave, but are unlikely to reduce pain. Multilevel focused interventions will probably result in decreased sick leave and provide some cost benefit. The evidence on productivity was limited and of poor quality. Further research is required because sustainable employment for individuals with PMP is important and understanding what works is necessary to ensure effective workplace interventions are developed.

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“…These data highlight the need for system reform initiatives to stem the flow of recurrent fractures among people with osteoporosis. 11 Our data suggest that 38% of patients with an index event are readmitted for fracture(s) within a 10-year period and more than 50% of these readmissions occur within the first year, highlighting this window as a critical period for preventive interventions.…”

Section: Discussionmentioning

confidence: 99%

Hospitalisations, admission costs and re‐fracture risk related to osteoporosis in Western Australia are substantial: a 10‐year review

Briggs

Sun

Miller

et al. 2015

Australian and New Zealand Journal of Public Health

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Moving from evidence to practice: Models of care for the prevention and management of musculoskeletal conditions

Cited by 102 publications

References 137 publications

The association between pediatric chronic pain clinic attendance and health care utilization: A retrospective analysis

The association between pediatric chronic pain clinic attendance and health care utilization: A retrospective analysis

Persistent musculoskeletal pain and productive employment; a systematic review of interventions

Hospitalisations, admission costs and re‐fracture risk related to osteoporosis in Western Australia are substantial: a 10‐year review

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