Musculoskeletal Diseases
Conditions
Keywords
Elderly, Disability, Musculoskeletal diseases
Brief summary
Objectives: To assess the efficacy of an intervention program targeted to the elderly with recent-onset disability of musculoskeletal origin (DIMS), and to perform its economic evaluation.
Detailed description
Methodology: 1) Controlled randomised intervention study (3 years). Subjects: persons older than 65 in health district 7 of Madrid with acute (\< 3 months) DIMS. Intervention group patients will be attended by rheumatologists acording with clinical (diagnostic and therapeutical) protocols. Control group will receive the routine attention from the Health System. Efficacy and costs variables will be collected through monthly structured telephone interviews performed by independent personnel blinded to the intervention group. Efficacy will be measured by differences between groups regarding: 1) time to improvement in the baseline DIMS episode, 2) number of subsequent DIMS, and 3) total number of DIMS days. An economic evaluation will be performed from a societal perspective.
Interventions
PROCEDURESpecific clinical care program
The rheumatologists acted as principal care providers in regular visits, home visits and phone contacts. The visits were structured following specific proceedings for the different diagnoses based on previously demonstrated approaches. Such protocols included education and promotion of independence, pharmacological and no pharmacological treatment, and timing of diagnostic tests in a stepwise manner. The program also incorporated administrative duties such as the prescription of medication for the patients. Patients were seen as often as necessary according to the medical rheumatologist decision (until the episode of disability was medically resolved).
Sponsors
Fundacion MAPFRE
Fundación Mutua Madrileña
Instituto de Salud Carlos III
La Caixa Foundation
Spanish Foundation of Rheumatology
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of Musculoskeletal disorder * Older than 64 years * To have disability measured with a) or b): 1. Rosser clasification: at least 4. 2. M.Gill questionnaire: To need help from other person to dress, to tidy up itself, to walk or to stand up. * Disability of recent onset:less than three months.(Patiens had a better functional situation before)
Exclusion criteria
* Recent surgery * Dementia with no family support * Institutionalized
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total number of DIMS days | Period of time in days until the patients recovers defined as: an improvement in at least one point in the Rosser disability level |
| Time to improvement in the baseline recent-onset disability episode of musculoskeletal origin (DIMS) | Period of time in days until the patients recovers defined as: an improvement in at least one point in the Rosser disability level |
| Number of subsequent DIMS | Period of time in days until the patients recovers defined as: an improvement in at least one point in the Rosser disability level |
Secondary
| Measure | Time frame |
|---|---|
| Direct and Indirect Costs | Period of time in days until the patients recovers defined as: an improvement in at least one point in the Rosser disability level |
Countries
Spain
Outcome results
None listed