Solutions are needed to prevent and control the large and growing burden of musculoskeletal conditions. G-MUSC has developed strategies for achieving this but implementation is a challenge for which models of care are now being used.

Models of Care

Implementing evidence-based prevention and care for individuals with MSK conditions requires planning and action. G-MUSC supports the use of Models of Care as a standardized way to help to evaluate need, complete comprehensive planning and identify the action steps required. Models of care have been developed in different countries and can be leveraged to help countries implement evidence-based programs.

What are Models of Care?

Models of Care are guides, frameworks or policies that outline the principles of care for particular conditions and how to implement care in a local setting. Models of Service Delivery are derived from Models of Care and take a service-level perspective.

Why are models important ?

Models allow for the best coordination of the resources that are available and highlight where additional resources are required.

Evaluating Musculoskeletal Models of Care

A team of Australian researchers, in partnership with the G-MUSC has developed the first internationally-informed framework for developing, implementing and evaluating musculoskeletal Models of Care.

What is the Framework?

The Framework is a document that identifies what needs to be in a Model of Care to make it effective. The Framework sets out actions to guide users in:

• The development process
• The implementation process
• The evaluation process

Who is the Framework for?

The Framework helps people who are planning, implementing or evaluating health services to achieve an optimal Model of Care and ultimately, system reform.

In line with the World Health Organization’s work to develop a guide to assist nations in assessing capacity to respond to the burden of cancer, diabetes, cardiovascular disease and lung diseases, this Framework assists nations meet their musculoskeletal health challenges through Models of Care. The Framework supports the Integrated Care for Older People (ICOPE) approach and Rehabilitation 2030 Agenda.

How was the framework developed?

The project was led by Associate Professor Andrew Briggs (Curtin University, Australia), the Framework was informed by experts from 30 nations, representing high, middle and low-income economies, using a phased research approach. The Framework is now supported by 54 peak international organisations and is used globally to inform Models of Care.

Why is it important?

As more people experience challenges from musculoskeletal conditions Models of Care will become increasingly important as a system-wide response. The Framework will help to support development efforts in Models of Care and offer an approach to standardising evaluation.

Download: Executive Summary here

Download: Full report here

Register your details here to receive updates about the Framework and other resources and learn about our future plans to promote models of care around the world. Read more here. For more information about Models of Care and how they have been used globally, refer to the special issue of Best Practice and Research Clinical Rheumatology.  

 

NCD Control

What are non-communicable conditions?

Non-communicable diseases (NCDs) are usually long‑term conditions (chronic conditions) resulting from a combination of genetic, physiological, environmental and behavioural factors. NCDs include musculoskeletal conditions.

Why are NCDs important?

NCDs now represent one of the most important issues in global health. Population health profiles are shifting, such that the impacts of NCDs are becoming greater across the lifecourse. Cancer, cardiovascular disease, lung disease and diabetes are the greatest contributors to premature deaths, accounting for about 70% of deaths globally. At the same time, the global population is ageing. People are living longer but not necessarily in good health, typically living with one or more NCDs. It is not surprising, therefore, that NCDs account for 80% of the global disability burden. Importantly, the disability burden is largely attributed to musculoskeletal conditions. Musculoskeletal conditions account for 16% of the total disability burden. Strong health systems rely on health policy that is responsive to current and emerging population health needs.

This report

This report aimed to systematically analyse health policies for Member States of the Organisation for Economic Co-operation and Development (OCED) to answer three important questions:

1. Which member states have health policies that focus on integrated prevention and/or management of NCDs?
2. What are the key features of such integrated health policies – their aims and strategies?
3. To what extent are musculoskeletal health conditions integrated with other NCDs in these policies?

What did we find?

A team of 13 international reviewers systematically analysed health policies focused on integrated prevention and/or management of NCDs among Member States of the (OECD). Included policies were those submitted to the World Health Organization as part of an NCD Country Capacity Survey. 44 policies of 30 OECD Member States were analysed. Policies described aims and strategies that focused on:

• General principles for people‑centred NCD prevention and management.
• Enhancing service delivery for people with, or at risk of, NCDs.
• Whole‑of‑system strengthening approaches to prevent and/or manage NCDs and improve population health.

Most countries had national policies that explicitly covered cancer (83.3%), cardiovascular disease (76.6%), diabetes/ endocrine disorders (76.6%), respiratory conditions (63.3%) and mental health conditions (63.3%). Half (50.0%) these countries had policies that explicitly included musculoskeletal health and/or persistent pain in their stated scope.

What are the implications of these findings?

Relative to other NCDs, musculoskeletal conditions featured less prominently as explicit foci among policies. Nonetheless, most of the strategies outlined across policies to combat NCDs were relevant to musculoskeletal conditions. The fact that half of the included OCED Member States had policies that explicitly targeted musculoskeletal conditions is promising and points to the growing awareness of the burden of disease associated with musculoskeletal conditions. Supporting other countries to expand the focus of health policy for NCDs to include musculoskeletal conditions and extending this analysis to other countries will be important. This project was led by Professor Andrew Briggs, Curtin University, Australia. Funding was provided by the Department of Health, Government of Western Australia and the Australian National Health and Medical Research Council.

Download the accompanying technical paper here: https://gh.bmj.com/content/4/5/e001806