Background: Patients with regional musculoskeletal pain (RMSKP) are at risk for work disability and instability and associated social and financial deprivation. Early intervention targeting prevention of work disability has potential to enhance patient outcomes and the effectiveness of care, with positive spill over effects for families, health services and the broader economy. Aims: This research aims: (1) to profile levels of work related disability/instability in patients in paid employment referred with RMSKP in Ireland; (2) to specify the content and delivery of an early integrated care intervention to improve work retention/participation, decrease distress, improve functional status, and increase health related quality of life among RMSKP patients; and (3) to feasibility test, pilot and evaluate the intervention in terms of efficacy and economic impact.
Study design and participants: The study will follow the UK MRC Framework (stages 1-3) for the development of complex interventions and will consist of 3 phases. Phase 1 will involve: (a) a systematic review to collate the evidence on interventions to prevent work disability and instability in RMSKP; and (b) a quantitative study to document levels of work related disability/instability in patients referred for RMSKP in Ireland. Phase 2 will involve a needs analysis of specific patient requirements to inform the intervention content. Phase 3 will involve: (a) specification of the content, components, mode and timing of the intervention; and (b) comprehensive feasibility and pilot testing with evaluation of patient outcomes and economic impact. Key deliverables: Description of RMSKP work-related disability/instability; Content and mode of delivery for the intervention; Pilot randomised control trial (RCT); Protocol for full RCT. Relevance: This proposal focuses on delivering innovation to achieve tangible health, social and economic gains, and enhanced healthcare system performance. Early intervention can improve health and participation, in RMSKP, realising patient and service benefits and economic gains.
