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Our team of internationally leading clinicians, researchers and educators have come together to reduce the gap between evidence and clinical practice in MSK disease.

The specific areas our team has targeted are Osteoarthritis, Osteoporosis and back pain.  These areas  were chosen as they are the largest contributors to the total societal burden and cost of MSK disease, both locally and globally. Despite their prevalence, each condition has proven difficult to manage effectively in front line clinical care. Our team aims to work together to improve how musculoskeletal conditions are diagnosed and managed, so that people have better outcomes and quality of life.

Activity

Low Back Pain Working Group
Low back pain is the single largest cause of disability worldwide. For many, the fears and worries that accompany low back pain contribute to ongoing pain, disability and professional healthcare seeking.

Not everyone with low back pain needs professional help and self-management is the best approach to recovery. Our group’s research project has shown that self-management can be encouraged by providing simple information about low back pain that reduces unnecessary fears.

This project addresses the challenge of delivering evidence-based information to the general public in an effective and cost-effective manner. We have partnered with a global advertising agency, Y&R Consulting, to develop a educational campaign to be delivered by social media to the general public.

The aim of the campaign is to:

AIM 1: reduce unwarranted fear about low back pain in the community

AIM 2: improve the capacity of the community to self-manage low back pain

AIM 3: reduce unnecessary healthcare use for low back pain


Osteoarthritis (OA)
OA is a common condition that causes a great deal of pain and disability in the community. The currently available pharmaceutical treatments have limited benefit but there are a range of other non-pharmaceutical therapies (exercise, weight loss etc) and surgical therapies eg hip and knee replacements, with good evidence for their effectiveness in this condition.

The OA working group was established to focus  on a range of studies aimed at closing the evidence practice gap in OA. The group is a multidisciplinary collaborative group made up of a range of highly skilled consumers, clinicians and researchers.

Effective treatments for OA have been incorporated into a range of guidelines but these are often not followed by clinicians. There is limited understanding of why such guidelines are not more commonly used in practice. One of our studies is examining the current gap between evidence and practice in a community physiotherapy setting and the reason for this gap. Understanding that will help us to define how to more effectively translate current evidence into practice so as to improve clinical outcomes.

We are committed to ensuring that our consumer and community partners are embedded in all aspects of our research and we welcome new collaborators who bring their own research questions and interests to the group.


Osteoporosis (OP) Working Group
Osteoporosis causes bones to become thinner and less dense which in turn can greatly increase the risk of a serious fracture. The osteoporosis working group aims to reduce the gap between evidence and clinical care with a specific emphasis on   refracture prevention. The team have divided their efforts into four themes; implementation, identification, ideas and opportunities.

The implementation team have the vital task of ensuring that the treatment gap in osteoporosis is closed. They have submitted numerous grants to fund comparative effectiveness studies of osteoporosis refracture prevention services that differ across member sites in resources, methods and engagement. What works at one site or is recommended in the literature may not necessarily be as effective at other sites and novel solutions and care bundles may need to be developed to overcome local blocks at South Eastern Sydney Local Health District (SESLHD), St Vincent’s Hospital, Sydney and South Western Sydney Local Health District (SWSLHD).

The wicked problem the working group now face is that the success of the identification team to locate patients at increased risk of fracture overwhelms the hospital based clinics that could support the service. New primary based models of care will be required to solve it. These will need to be developed and tested for their effectiveness by the implementation team.

The identification group have concentrated on newer machine based and natural language processing to identify patients at risk of fracture. Supported by an Innovation grant from SESLHD to develop a working prototype, we have designed and tested a new case finding tool that reads radiology reports in real time. It detects 99% sensitivity and 93% specificity for minimal trauma fracture. The tool has also been designed to recruit patients into clinical trials and observational studies for osteoporosis refracture prevention and has been rolled out across SESLHD.

The ideas team has put forward a multinational clinical trial for the novel use of bisphosphonates in the Intensive Care Unit (ICU) survivors to decrease mortality and improve MSK outcomes. This group is also involved in a project investigating a possible link between diabetes and bone biology at The George Institute.

The opportunities team has successfully developed a pipeline of PhD and scholarships that will fund the next generation of clinician researchers to lead translational research in musculoskeletal medicine.

Team

The MSK CAG brings leaders together in consumer advocacy, allied health, pain science, nursing, education, IT, implementation science and medicine. Our members come from multiple academic, health and consumer organisations to form a sustainable, collaborative group.

The musculoskeletal community (patients, consumers and families) works closely with us to co-design, conduct and deliver research projects.

It’s the depth and breadth of many partnerships that are our strength. Through them, we will improve outcomes for patients with musculoskeletal disease across the world. We’ll also be recognised as a leader in translating evidence-based care for people with osteoporosis, back pain and osteoarthritis.

Vision

To optimise MSK health and reduce community disease burden through the translation of high quality evidence-based care for osteoarthritis, osteoporosis and back pain. 

Impact
Education Research Collaboration

- PhD & Fellowship programs established across our streams: Osteoarthritis, Osteoporosis and Back pain.

- XRAIT installed in SESLHD and recruits 100 patients p/month into ORP intervention and trials.

- Recruited 5 consumer representatives and established a Consumer Council to inform priority setting and research directions. This will ensure consumers are embedded in critical research projects from design initiation through to implementation.

- Created collaborations between GPs, orthopaedics, rheumatology, psychology, physiotherapy and podiatry across LHDs and interstate that did not exist 12 months ago.

- United a wide range of individuals with different perspectives and skills to solve real-world translational health problems in an area of major disease burden. This should provide a foundation for translational research excellence.

Reduce musculoskeletal pain:

For more information on our work, please contact Kate Luckie, Project Officer.