A comparison of routine and case-managed pathways for recovery from musculoskeletal disorders in people in employment

Bergman, B. P., Demou, E. , Lewsey, J. and Macdonald, E. (2021) A comparison of routine and case-managed pathways for recovery from musculoskeletal disorders in people in employment. Disability and Rehabilitation, (doi: 10.1080/09638288.2021.1912837) (PMID:33896322) (Early Online Publication)

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Abstract

Purpose: To compare outcomes in employed people from an enhanced routine management pathway for musculoskeletal disorders within National Health Service Scotland with an existing active case-management system, Working Health Services Scotland. Materials and methods: The study comprised a service evaluation using anonymised routinely collected data from all currently employed callers presenting with musculoskeletal disorder to the two services. Baseline demographic and clinical data were collected. EuroQol EQ-5DTM scores at the start and end of treatment were compared for both groups, overall and by age, sex, socio-economic status, and anatomical site, and the impact of mental health status at baseline was evaluated. Results: Active case-management resulted in greater improvement than enhanced routine care. Case-managed service users entered the programme earlier in the recovery pathway; there was evidence of spontaneous improvement during the longer waiting time of routine service clients but only if they had good baseline mental health. Those most disadvantaged through mental health co-morbidity showed the greatest benefit. Conclusions: People with musculoskeletal disorders who have poor baseline mental health status derive greatest benefit from active case-management. Case-management therefore contributes to reducing health inequalities and can help to minimise long-term sickness absence. Shorter waiting times contributed to better outcomes in the case-managed service.

Item Type:Articles
Additional Information:This study was funded by a Scottish Government Award for the evaluation of the redesigned MSK Service and a Scottish Government/Salus Award for the evaluation of the WHSS service. E Demou was also supported by the MRC Strategic Award MC_PC_13027.
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Bergman, Dr Beverly and MacDonald, Professor Ewan and Lewsey, Professor Jim and Demou, Dr Evangelia
Authors: Bergman, B. P., Demou, E., Lewsey, J., and Macdonald, E.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Disability and Rehabilitation
Publisher:Taylor & Francis
ISSN:0963-8288
ISSN (Online):1464-5165
Published Online:25 April 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Disability and Rehabilitation 2021
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
168560MRC SPHSU/GU Transfer FellowshipsLaurence MooreMedical Research Council (MRC)MC_PC_13027HW - MRC/CSO Social and Public Health Sciences Unit
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
Chief Scientist Office (CSO)SPHSU13