Preventing Disability from MSK Pain in Northern Tanzania

预防坦桑尼亚北部 MSK 斯隆疼痛造成的残疾

基本信息

批准号：
10264053
负责人：
Adam Goode
金额：
$ 6.43万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-15 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10264053
关键词：
Activities of Daily Living Address Adherence Africa Age Ambulatory Care Arthralgia Arthritis Attention Awareness Car Phone Caring Clinic Clinical Collaborations Community Participation Country Degenerative polyarthritis Effectiveness Elderly Exercise Exercise Therapy Future Geography Goals Health Health Services Accessibility Healthcare Home Hospitals Image Impaired cognition Individual Institutes Internist Intervention Knowledge Left Life Expectancy Low Back Pain Low income Measurement Measures Methods Modeling Musculoskeletal Musculoskeletal Diseases Musculoskeletal Pain Orthopedics Pain Patient Self-Report Patients Pharmaceutical Preparations Physical activity Physical therapy Prevalence Productivity Recommendation Research Rheumatoid Arthritis Risk Role Rural Service delivery model Services Specialist Surgeon Tanzania Text Text Messaging Text Telephone Translations United States United States National Institutes of Health Veterans Work chronic pain cognitive function cost design disability experience functional decline implementation framework implementation research improved improved functioning innovation intervention refinement low income country mHealth mortality pain reduction physical therapist poor sleep population health prevent programs research study rheumatologist scale up telephone coaching theories therapy development years lived with disability

项目摘要

Abstract Musculoskeletal pain can be debilitating. Left untreated, musculoskeletal pain leads to functional decline, independent of other health conditions, that for older adults is known to increase the risk for cognitive decline and even mortality. Common practice for addressing chronic pain—pain that is lasting more than three months—is to refer people to specialists such as rheumatologists or orthopaedic surgeons, or to obtain expensive imaging and medications. Less often are non-pharmacological interventions prescribed with a particular focus on exercise as therapy despite demonstrated effectiveness. Physical therapy-led exercise therapy holds great promise for delivering high value care for individuals with musculoskeletal pain or limitations in daily activities. The significance of the physical therapists role in caring for people with joint pain or with arthritis is heightened in low-income settings where access to specialists is limited, and greater attention to unnecessary prescribing of images and medications is needed. There is a critical need to establish new models of musculoskeletal care in low-income countries like where we will focus in Northern Tanzania because life expectancy is increasing and yet, more people are living with disability. Low back pain, for example, is the second leading cause of disability in Tanzania and the rate of disabling low back pain has increased 36% from 2007 to 2017. Research collaborations across countries can help build capacity and support translation of effective care models for improved population health. Our five year goal is to have implemented a model of care that expands access to physical therapists using text and telephone support of exercise at home in even rural and remote villages. Our proposed two-year implementation research study builds on existing partnerships to adapt and plan for scaling up an intervention we found effective with older adult Veterans in the United States. Guided by the Institute for Healthcare Improvement Framework for Going to Full Scale, we will accomplish two specific aims. (1) Explore the feasibility, reach, appropriateness, acceptability, and costs of an innovative MSK care model for Northern Tanzania compared with current practice. (2) Adapt and refine the physical therapy, text message and telephone counseling components of the model to be locally relevant and expand availability and access to care. The scalable intervention and new knowledge generated from the proposed implementation research will guide our research team to go full scale in Northern Tanzania and spread to other regions for improved population health.

抽象的如果不及时治疗，肌肉骨骼疼痛可能会导致功能下降。与其他健康状况无关，众所周知，老年人认知能力下降的风险会增加解决慢性疼痛（持续超过三年的疼痛）的常见做法。几个月——将人们转介给风湿科医生或整形外科医生等专家，或者获得很少采用影像学和药物治疗。尽管物理治疗主导的运动已被证明有效，但仍特别注重运动作为治疗。该疗法有望为肌肉骨骼疼痛或肌肉骨骼疼痛患者提供高价值护理。日常活动的限制物理治疗师在护理关节疼痛患者中的重要性。或关节炎是低收入环境下的哮喘，那里获得专家的机会有限，而且更多需要注意不必要的影像和药物处方，迫切需要建立。低收入国家的肌肉骨骼护理新模式，例如我们将重点关注的坦桑尼亚北部地区因为预期寿命在增加，但越来越多的人患有腰痛。例如，腰痛是坦桑尼亚第二大致残原因，腰痛致残率已从 2007 年到 2017 年增加了 36%。各国之间的研究合作有助于能力建设和支持转化有效的护理模式以改善人口健康。我们的五年目标是：实施了一种护理模式，通过短信和电话支持扩大物理治疗师的接触范围我们提出了为期两年的实施研究。以现有伙伴关系为基础，调整和计划扩大我们发现对老年人有效的干预措施美国成年退伍军人由医疗保健改善框架研究所指导。 (1) 探讨可行性、可达性、适当性、与当前相比，坦桑尼亚北部创新 MSK 斯隆护理模式的可接受性和成本 (2) 调整和完善物理治疗、短信和电话咨询部分。模式与当地相关，并扩大可扩展的干预措施和新的护理的可及性和可及性。从拟议的研究实施中产生的知识将指导我们的研究团队全面展开坦桑尼亚北部并传播到其他地区以改善人口健康。