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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：
10095260
负责人：
Janet Alexandria Prvu Bettger
金额：
$ 7.96万
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 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10095260
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 Counseling Country Degenerative polyarthritis Effectiveness Elderly Exercise Exercise Therapy Future Geography Goals Health Health Services Accessibility Healthcare Home environment 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 Sleep disturbances Specialist Surgeon Tanzania Telephone 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 research improved improved functioning innovation low income country mHealth mortality pain reduction physical therapist population health prevent programs research study rheumatologist scale up 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.

摘要