Common musculoskeletal conditions

The Global Burden of Disease study identified musculoskeletal (MSK) conditions as the largest single cause of years lived with disability. MSK medicine and rehabilitation services worldwide are heterogeneous in nature in terms of patient pathway and involvement of various healthcare professionals. The service can be led by consultants in different medical specialties; in primary care by General Practitioners with a special interest in MSK disorders and in secondary care by rheumatologists, orthopaedic surgeons, neurosurgeons, pain specialists, rehabilitation and MSK physicians. Allied health professionals such as physiotherapists and extended scope practitioners now have a far greater role in managing MSK conditions in some countries such as the UK.

Download Full-text

Improving access to allied health professionals through the Champlain BASE™eConsult service: a cross-sectional study in Canada

British Journal of General Practice ◽

10.3399/bjgp17x693125 ◽

2017 ◽

Vol 67 (664) ◽

pp. e757-e763 ◽

Cited By ~ 2

Author(s):

Fanny McKellips ◽

Erin Keely ◽

Amir Afkham ◽

Clare Liddy

Keyword(s):

Primary Care ◽

Health Services ◽

Health Professionals ◽

Allied Health ◽

Primary Care Providers ◽

Cross Sectional Study ◽

Sectional Study ◽

Allied Health Professionals ◽

Cross Sectional ◽

Medical Specialties

BackgroundAllied health services are an important part of providing effective team-based care. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service facilitates quick and secure communication between primary care providers (PCPs) and allied health professionals (AHPs).AimTo assess the eConsult service’s ability to improve access to advice from AHPs.Design and settingA cross-sectional study was carried out on all cases submitted to AHPs through the eConsult service between April 2011 and May 2016. The service covers Ottawa, Canada, and its surrounding rural communities.MethodA descriptive overview of all cases submitted to allied health services was conducted. Utilisation and survey metrics for AHP eConsults were compared with those sent to medical specialties, in order to understand the potential differences and generalisability of eConsult access beyond the traditional medical specialty referral.ResultsPCPs submitted 127 cases to nine allied health specialties during the study period. The most popular specialty was clinical pharmacist, which received an average of 1.5 cases per month. The median specialist response time was 2.1 days (interquartile range [IQR] 0.7–5.3 days, range 0.01–14.2 days) versus 0.9 days (IQR 0.2–3.4 days, range 0–49.5 days) for medical specialties. PCPs received advice for a new or additional course of action in 70% (versus 58% for medical specialties) of cases. They rated the service as being of high or very high value for their patients in 88% of cases (versus 93% for medical specialties), and for themselves in 89% (94% for medical specialties) of cases.ConclusionThe eConsult service has demonstrated the ability to support prompt communication between PCPs and AHPs, improving patients’ access to AHP care. Given the importance of AHPs in providing primary care, allied health services should be offered in the menu of specialties available through electronic consultation services.

Download Full-text

Faculty Opinions recommendation of Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.731220250.793569875 ◽

2020 ◽

Cited By ~ 21

Author(s):

Yuguang Huang ◽

Xiaohan Xu

Keyword(s):

Burden Of Disease ◽

Global Burden Of Disease ◽

Global Burden ◽

Systematic Analysis ◽

Disease Study ◽

Years Lived With Disability ◽

Incidence Prevalence

Download Full-text

Faculty Opinions recommendation of Changes in health in the countries of the UK and 150 English Local Authority areas 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.734283110.793552208 ◽

2018 ◽

Author(s):

Michael Symonds

Keyword(s):

Burden Of Disease ◽

Local Authority ◽

Global Burden Of Disease ◽

Global Burden ◽

Systematic Analysis ◽

Disease Study ◽

The Uk

Download Full-text

The value of a consultant physiotherapist within a primary care musculoskeletal interface service: part of the spinal multidisciplinary team

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2019.0057 ◽

2021 ◽

Vol 28 (1) ◽

pp. 1-10

Author(s):

Michelle L Angus ◽

Victoria Dickens ◽

Naveed Yasin ◽

James Greenwood ◽

Irfan Siddique

Keyword(s):

Primary Care ◽

Clinical Decision Making ◽

Clinical Decision ◽

Tertiary Referral Centre ◽

Allied Health Professionals ◽

Convenience Sample ◽

Surgical Services ◽

Pain Pathway ◽

The Uk ◽

Case Based

Background/aims The national low back pain pathway in the UK suggests practitioners managing patients with spinal pathology should be specifically trained to do so and have the ability to link with tertiary spinal services when required. The aim of this study was to ensure referrals through to a tertiary spinal surgical centre are appropriate and patients get the correct advice early in their management pathway. Methods A retrospective review of 700 cases were discussed at a spinal case-based discussion meeting in a primary care interface service, compared to services without this model. A convenience sample of cases were analysed with the consultant physiotherapist and those referred from other allied health professionals into the tertiary spinal surgical centre. Case-based team discussion took place before every referral into the tertiary spinal service, with spinal surgical discussion where required. Results Patients referred from other interface services were more likely to require further work-up such as investigations, or be discharged from clinic on their first attendance than those who had been through the case-based discussion. Conclusions A consultant physiotherapist working as part of the spinal team of a tertiary referral centre can help advanced practitioners with their clinical decision making to help prevent unnecessary referrals to spinal surgical services.

Download Full-text

Framing obesity: disease status, language and stigma

Practice Nursing ◽

10.12968/pnur.2019.30.9.448 ◽

2019 ◽

Vol 30 (9) ◽

pp. 448-451 ◽

Cited By ~ 1

Author(s):

Hilda Mulrooney

Keyword(s):

Primary Care ◽

Environmental Factors ◽

Health Professionals ◽

First Language ◽

Healthcare Quality ◽

Disease Status ◽

Change Perceptions ◽

Related Stigma ◽

People First ◽

The Uk

The way that health professionals talk about conditions is crucial to patient-centred care. Hilda Mulrooney explains how obesity is a condition that is often framed in negative language that needs to be changed in order to improve healthcare quality in primary care The language and images used to describe those living with obesity are often stigmatising. They can contribute to the perception that those with obesity are responsible for their own condition. Much of the rhetoric around excess weight emphasises actions that individuals can take. This ignores the complexity of how weight is gained and retained, and the roles of genetics and environmental factors. In the UK, those advocating for obesity to be recognised as a disease suggest that this may reduce levels of weight-related stigma. The use of non-stigmatising images and people-first language are recommended to help change perceptions of blame around obesity.

Download Full-text

The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867417751641 ◽

2018 ◽

Vol 52 (5) ◽

pp. 483-490 ◽

Cited By ~ 9

Author(s):

Liliana G Ciobanu ◽

Alize J Ferrari ◽

Holly E Erskine ◽

Damian F Santomauro ◽

Fiona J Charlson ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Burden Of Disease ◽

Global Burden Of Disease ◽

Global Burden ◽

Years Of Life Lost ◽

Disability Adjusted Life ◽

Life Years ◽

Disease Study ◽

Years Lived With Disability

Objectives: Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. Methods: For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Results: Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Conclusion: Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.

Download Full-text