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.

抽象的肌肉骨骼疼痛可能使人衰弱。剩下的未治疗的肌肉骨骼疼痛导致功能下降，独立于其他健康状况，众所周知，老年人会增加认知能力下降的风险甚至死亡率。解决慢性疼痛的常见做法 - 持续三个以上几个月 - 将人们推荐给流变学家或骨科医生等专家，或获得昂贵的成像和药物。不少于非药理学干预措施特别关注锻炼，因为治疗有效地成功。物理治疗主导的运动治疗对肌肉骨骼疼痛或日常活动的限制。物理治疗师在照顾关节疼痛患者中的重要性或患有关节炎的低收入环境有限且更大的低收入环境。需要注意图像和药物的不必要的处方。建立迫切需要低收入国家的肌肉骨骼护理的新模式，例如我们将重点放在坦桑尼亚北部因为预期寿命正在增加，但越来越多的人患有残疾人。腰痛，因为例如，是坦桑尼亚残疾的第二大主要原因，残疾腰痛的率具有从2007年到2017年增长了36％。各个国家的研究合作可以帮助建立能力和支持改善人口健康的有效护理模型的翻译。我们的五年目标是实施了一种护理模型，该模型通过文本和电话支持扩展了对物理治疗师的访问在家里甚至在农村和偏远村庄中锻炼。我们提出的两年实施研究建立在现有合作伙伴关系的基础上，以适应和计划扩大我们发现对较旧的干预措施的规模美国的成年退伍军人。在医疗保健改进研究所的指导下全面扩展，我们将实现两个具体的目标。（1）探索可行性，覆盖率，适当性，与当前实践。（2）适应并完善并完善物理疗法，短信和电话咨询组件模型是本地相关的，并扩大可用性和获得护理的访问。可扩展干预和新的拟议的实施研究产生的知识将指导我们的研究团队进行全面扩展在坦桑尼亚北部，并蔓延到其他地区，以改善人口健康。