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Mesa-Castrillon CI, Beckenkamp PR, Ferreira M, Simic M, Davis PR, Michell A, Pappas E, Luscombe G, Noronha MD, Ferreira P. Global prevalence of musculoskeletal pain in rural and urban populations. A systematic review with meta-analysis. Musculoskeletal pain in rural and urban populations. Aust J Rural Health 2024. [PMID: 38963186 DOI: 10.1111/ajr.13161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/10/2024] [Accepted: 06/16/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION To systematically compare the global prevalence of musculoskeletal pain and care-seeking in rural and urban populations. METHODS A systematic review with meta-analysis of observational studies reporting a direct comparison of rural and urban populations was conducted worldwide and included back, knee, hip, shoulder, neck pain and a broad diagnosis of 'musculoskeletal pain'. A search strategy combining terms related to 'prevalence', 'musculoskeletal pain' and 'rural' was used on the following databases: MEDLINE, Embase, CINAHL, Scopus, and rural and remote health from their inception to 1 June 2022. Random-effects meta-analysis was used to pool the data. Results were presented as odds ratios (OR) along with 95% confidence intervals (95% CI). RESULTS A total of 42 studies from 24 countries were included with a total population of 489 439 participants. The quality scores for the included studies, using the modified Newcastle Ottawa Scale tool, showed an average score of 0.78/1, which represents an overall good quality. The pooled analysis showed statistically greater odds of hip (OR = 1.62, 95% CI = 1.23-2.15), shoulder (OR = 1.42, 95% CI = 1.06-1.90) and overall musculoskeletal pain (OR = 1.26, 95% CI = 1.08-1.47) in rural populations compared to urban populations. Although the odds of seeking treatment were higher in rural populations this relationship was not statistically significant (OR = 0.76, 95% CI = 0.55-1.03). CONCLUSION Very low-certainty evidence suggests that musculoskeletal, hip and shoulder pain are more prevalent in rural than urban areas, although neck, back and knee pain, along with care-seeking, showed no significant difference between these populations. Strategies aimed to reduce the burden of musculoskeletal pain should consider the specific needs and limited access to quality evidence-based care for musculoskeletal pain of rural populations.
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Affiliation(s)
- Carlos I Mesa-Castrillon
- Faculty of Medicine and Health, Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Rural Health, Faculty of Medicine and Health, The University of Sydney, Orange Campus, Orange, New South Wales, Australia
| | - Paula R Beckenkamp
- Faculty of Medicine and Health, Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Manuela Ferreira
- School of Health Sciences, Faculty of Medicine and Health, Sydney Musculoskeletal Health, The Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Milena Simic
- Faculty of Medicine and Health, Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Phillip R Davis
- Faculty of Medicine and Health, Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Antonio Michell
- Faculty of Medicine and Health, Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Evangelos Pappas
- Faculty of Medicine and Health, Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
- The University of Wollongong, Wollongong, New South Wales, Australia
| | - Georgina Luscombe
- School of Rural Health, Faculty of Medicine and Health, The University of Sydney, Orange Campus, Orange, New South Wales, Australia
| | - Marcos De Noronha
- Rural Department of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Paulo Ferreira
- Faculty of Medicine and Health, Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
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Wu AM, Cross M, Elliott JM, Culbreth GT, Haile LM, Steinmetz JD, Hagins H, Kopec JA, Brooks PM, Woolf AD, Kopansky-Giles DR, Walton DM, Treleaven JM, Dreinhoefer KE, Betteridge N, Abbasifard M, Abbasi-Kangevari Z, Addo IY, Adesina MA, Adnani QES, Aithala JP, Alhalaiqa FAN, Alimohamadi Y, Amiri S, Amu H, Antony B, Arabloo J, Aravkin AY, Asghari-Jafarabadi M, Atomsa GH, Azadnajafabad S, Azzam AY, Baghdadi S, Balogun SA, Balta AB, Banach M, Banakar M, Barrow A, Bashiri A, Bekele A, Bensenor IM, Bhardwaj P, Bhat AN, Bilchut AH, Briggs AM, Buchbinder R, Cao C, Chaurasia A, Chirinos-Caceres JL, Christensen SWM, Coberly K, Cousin E, Dadras O, Dai X, de Luca K, Dehghan A, Dong HJ, Ekholuenetale M, Elhadi M, Eshetu HB, Eskandarieh S, Etaee F, Fagbamigbe AF, Fares J, Fatehizadeh A, Feizkhah A, Ferreira ML, Ferreira N, Fischer F, Franklin RC, Ganesan B, Gebremichael MA, Gerema U, Gholami A, Ghozy S, Gill TK, Golechha M, Goleij P, Golinelli D, Graham SM, Haj-Mirzaian A, Harlianto NI, Hartvigsen J, Hasanian M, Hassen MB, Hay SI, Hebert JJ, Heidari G, Hoveidaei AH, Hsiao AK, Ibitoye SE, Iwu CCD, Jacob L, Janodia MD, Jin Y, Jonas JB, Joshua CE, Kandel H, Khader YS, Khajuria H, Khan EA, Khan MAB, Khatatbeh MM, Khateri S, Khayat Kashani HR, Khonji MS, Khubchandani J, Kim YJ, Kisa A, Kolahi AA, Koohestani HR, Krishan K, Kuddus M, Kuttikkattu A, Lasrado S, Lee YH, Legesse SM, Lim SS, Liu X, Lo J, Malih N, Manandhar SP, Mathews E, Mesregah MK, Mestrovic T, Miller TR, Mirghaderi SP, Misganaw A, Mohammadi E, Mohammed S, Mokdad AH, Momtazmanesh S, Moni MA, Mostafavi E, Murray CJL, Nair TS, Nejadghaderi SA, Nzoputam OJ, Oh IH, Okonji OC, Owolabi MO, Pacheco-Barrios K, Pahlevan Fallahy MT, Park S, Patel J, Pawar S, Pedersini P, Peres MFP, Petcu IR, Pourahmadi M, Qattea I, Ram P, Rashidi MM, Rawaf S, Rezaei N, Rezaei N, Saeed U, Saheb Sharif-Askari F, Salahi S, Sawhney M, Schumacher AE, Shafie M, Shahabi S, Shahbandi A, Shamekh A, Sharma S, Shiri R, Shobeiri P, Sinaei E, Singh A, Singh JA, Singh P, Skryabina AA, Smith AE, Tabish M, Tan KK, Tegegne MD, Tharwat S, Vahabi SM, Valadan Tahbaz S, Vasankari TJ, Venketasubramanian N, Vollset SE, Wang YP, Wiangkham T, Yonemoto N, Zangiabadian M, Zare I, Zemedikun DT, Zheng P, Ong KL, Vos T, March LM. Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. THE LANCET. RHEUMATOLOGY 2024; 6:e142-e155. [PMID: 38383088 PMCID: PMC10897950 DOI: 10.1016/s2665-9913(23)00321-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND Neck pain is a highly prevalent condition that leads to considerable pain, disability, and economic cost. We present the most current estimates of neck pain prevalence and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) by age, sex, and location, with forecasted prevalence to 2050. METHODS Systematic reviews identified population-representative surveys used to estimate the prevalence of and YLDs from neck pain in 204 countries and territories, spanning from 1990 to 2020, with additional data from opportunistic review. Medical claims data from Taiwan (province of China) were also included. Input data were pooled using DisMod-MR 2.1, a Bayesian meta-regression tool. Prevalence was forecast to 2050 using a mixed-effects model using Socio-demographic Index as a predictor and multiplying by projected population estimates. We present 95% UIs for every metric based on the 2·5th and 97·5th percentiles of 100 draws of the posterior distribution. FINDINGS Globally, in 2020, neck pain affected 203 million (95% uncertainty interval [UI] 163-253) people. The global age-standardised prevalence rate of neck pain was estimated to be 2450 (1960-3040) per 100 000 population and global age-standardised YLD rate was estimated to be 244 (165-346) per 100 000. The age-standardised prevalence rate remained stable between 1990 and 2020 (percentage change 0·2% [-1·3 to 1·7]). Globally, females had a higher age-standardised prevalence rate (2890 [2330-3620] per 100 000) than males (2000 [1600-2480] per 100 000), with the prevalence peaking between 45 years and 74 years in male and female sexes. By 2050, the estimated global number of neck pain cases is projected to be 269 million (219-322), with an increase of 32·5% (23·9-42·3) from 2020 to 2050. Decomposition analysis of the projections showed population growth was the primary contributing factor, followed by population ageing. INTERPRETATION Although age-standardised rates of neck pain have remained stable over the past three decades, by 2050 the projected case numbers are expected to rise. With the highest prevalence in older adults (higher in females than males), a larger effect expected in low-income and middle-income countries, and a rapidly ageing global population, neck pain continues to pose a challenge in terms of disability burden worldwide. For future planning, it is essential we improve our mechanistic understanding of the different causes and risk factors for neck pain and prioritise the consistent collection of global neck pain data and increase the number of countries with data on neck pain. FUNDING Bill & Melinda Gates Foundation and Global Alliance for Musculoskeletal Health.
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Gill TK, Mittinty MM, March LM, Steinmetz JD, Culbreth GT, Cross M, Kopec JA, Woolf AD, Haile LM, Hagins H, Ong KL, Kopansky-Giles DR, Dreinhoefer KE, Betteridge N, Abbasian M, Abbasifard M, Abedi K, Adesina MA, Aithala JP, Akbarzadeh-Khiavi M, Al Thaher Y, Alalwan TA, Alzahrani H, Amiri S, Antony B, Arabloo J, Aravkin AY, Arumugam A, Aryal KK, Athari SS, Atreya A, Baghdadi S, Bardhan M, Barrero LH, Bearne LM, Bekele AB, Bensenor IM, Bhardwaj P, Bhatti R, Bijani A, Bordianu T, Bouaoud S, Briggs AM, Cheema HA, Christensen SWM, Chukwu IS, Clarsen B, Dai X, de Luca K, Desye B, Dhimal M, Do TC, Fagbamigbe AF, Farokh Forghani S, Ferreira N, Ganesan B, Gebrehiwot M, Ghashghaee A, Graham SM, Harlianto NI, Hartvigsen J, Hasaballah AI, Hasanian M, Hassen MB, Hay SI, Heidari M, Hsiao AK, Ilic IM, Jokar M, Khajuria H, Khan MJ, Khanal P, Khateri S, Kiadaliri A, Kim MS, Kisa A, Kolahi AA, Krishan K, Krishnamoorthy V, Landires I, Larijani B, Le TTT, Lee YH, Lim SS, Lo J, Madani SP, Malagón-Rojas JN, Malik I, Marateb HR, Mathew AJ, Meretoja TJ, Mesregah MK, Mestrovic T, Mirahmadi A, Misganaw A, Mohaghegh S, Mokdad AH, Momenzadeh K, Momtazmanesh S, Monasta L, Moni MA, Moradi Y, Mostafavi E, Muhammad JS, Murray CJL, Muthu S, Nargus S, Nassereldine H, Neupane S, Niazi RK, Oh IH, Okati-Aliabad H, Oulhaj A, Pacheco-Barrios K, Park S, Patel J, Pawar S, Pedersini P, Peres MFP, Petcu IR, Petermann-Rocha FE, Poursadeqiyan M, Qattea I, Qureshi MF, Rafferty Q, Rahimi-Dehgolan S, Rahman M, Ramasamy SK, Rashedi V, Redwan EMM, Ribeiro DC, Roever L, Safary A, Sagoe D, Saheb Sharif-Askari F, Sahebkar A, Salehi S, Shafaat A, Shahabi S, Sharma S, Shashamo BB, Shiri R, Singh A, Slater H, Smith AE, Sunuwar DR, Tabish M, Tharwat S, Ullah I, Valadan Tahbaz S, Vasankari TJ, Villafañe JH, Vollset SE, Wiangkham T, Yonemoto N, You Y, Zare I, Zheng P, Vos T, Brooks PM. Global, regional, and national burden of other musculoskeletal disorders, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. THE LANCET. RHEUMATOLOGY 2023; 5:e670-e682. [PMID: 37927903 PMCID: PMC10620749 DOI: 10.1016/s2665-9913(23)00232-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431-564) people had other musculoskeletal disorders in 2020, an increase of 123·4% (116·9-129·3) in total cases from 221 million (192-253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107-124) from 2020 to 2050, to an estimated 1060 million (95% UI 964-1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47·4% (44·9-49·4) higher in females than in males and increased with age to a peak at 65-69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42·7 million [29·4-60·0]) and was associated with 83 100 deaths (73 600-91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data. Funding Bill & Melinda Gates Foundation.
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Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. THE LANCET. RHEUMATOLOGY 2023; 5:e316-e329. [PMID: 37273833 PMCID: PMC10234592 DOI: 10.1016/s2665-9913(23)00098-x] [Citation(s) in RCA: 197] [Impact Index Per Article: 197.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. Methods Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates. Findings In 2020, low back pain affected 619 million (95% uncertainty interval 554-694) people globally, with a projection of 843 million (759-933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578-1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9-10·0) and 10·5% (11·1-10·0), respectively. A total of 38·8% (28·7-47·0) of YLDs were attributed to occupational factors, smoking, and high BMI. Interpretation Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change. Funding Bill and Melinda Gates Foundation.
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de Luca K, Briggs AM, French SD, Ferreira ML, Cross M, Blyth F, March L. Disability burden due to musculoskeletal conditions and low back pain in Australia: findings from GBD 2019. Chiropr Man Therap 2022; 30:22. [PMID: 35505334 PMCID: PMC9063272 DOI: 10.1186/s12998-022-00434-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report the national prevalence, years lived with disability (YLDs) and attributable risk factors for all musculoskeletal conditions and separately for low back pain (LBP), as well as compare the disability burden related to musculoskeletal with other health conditions in Australia in 2019. METHODS Global Burden of Disease (GBD) 2019 study meta-data on all musculoskeletal conditions and LBP specifically were accessed and aggregated. Counts and age-standardised rates, for both sexes and across all ages, for prevalence, YLDs and attributable risk factors are reported. RESULTS In 2019, musculoskeletal conditions were estimated to be the leading cause of YLDs in Australia (20.1%). There were 7,219,894.5 (95% UI: 6,847,113-7,616,567) prevalent cases of musculoskeletal conditions and 685,363 (95% UI: 487,722-921,471) YLDs due to musculoskeletal conditions. There were 2,676,192 (95% UI: 2,339,327-3,061,066) prevalent cases of LBP and 298,624 (95% UI: 209,364-402,395) YLDs due to LBP. LBP was attributed to 44% of YLDs due to musculoskeletal conditions. In 2019, 22.3% and 39.8% of YLDs due to musculoskeletal conditions and LBP, respectively, were attributed to modifiable GBD risk factors. CONCLUSIONS The ongoing high burden due to musculoskeletal conditions impacts Australians across the life course, and in particular females and older Australians. Strategies for integrative and organisational interventions in the Australian healthcare system should support high-value care and address key modifiable risk factors for disability such as smoking, occupational ergonomic factors and obesity.
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Affiliation(s)
- Katie de Luca
- Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQUniversity, Brisbane, Australia.
| | - Andrew M Briggs
- Curtin School of Allied Health and Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Global Alliance for Musculoskeletal Health, Sydney, Australia
| | - Simon D French
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Marita Cross
- Global Alliance for Musculoskeletal Health, Sydney, Australia
- Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Fiona Blyth
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lyn March
- Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia
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Abstract
Low back pain (LBP) is the leading cause of disability in the low- and middle-income countries (LMICs), imposing substantial burden on individuals and health systems. The societal burden of LBP in LMICs challenges the United Nations' Sustainable Development Goals of eliminating poverty and improving health and well-being by pushing the people with the lowest socioeconomic position on the planet to greater poverty and more disability. This LBP in LMICs Series aims to (1) summarize the current state of LBP management in LMICs, (2) propose what best care for LBP in LMICs may look like, and (3) provide policy recommendations and a call to action. In this first paper, we summarize the extent of the problem: the prevalence, disability, and costs of LBP in LMICs. J Orthop Sports Phys Ther 2022;52(5):233-235. doi:10.2519/jospt.2022.11145.
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Hong P, Song YG, Paek S. Possible effects of agent orange and posttraumatic stress disorder on hyperglycemia in Korean veterans from the US-Vietnam war. Medicine (Baltimore) 2021; 100:e26508. [PMID: 34160471 PMCID: PMC8238358 DOI: 10.1097/md.0000000000026508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 05/12/2021] [Indexed: 01/04/2023] Open
Abstract
This study was conducted to examine whether Korean veterans from the US-Vietnam War who had a diagnosis of type II diabetes mellitus (T2DM) as well as past history of exposure to agent orange (AO) are vulnerable to hyperglycemia when receiving intra-articular corticosteroid injection (IACI) for pain relief.The current study included a total of 49 patients (n = 49) who received an injection of triamcinolone 20 or 40 mg to the shoulder under sonographic guidance or did that of dexamethasone 10 mg or triamcinolone 40 mg combined with dexamethasone 20 mg to the spine under fluoroscopic guidance. Their 7-day fasting blood glucose (FBG) levels were measured and then averaged, serving as baseline levels. This is followed by measurement of FBG levels for 14 days of IACI. Respective measurements were compared with baseline levels. The patients were also evaluated for whether there are increases in FBG levels depending on insulin therapy as well as HbA1c ≥ 7% or HbA1c < 7%.Overall, there were significant increases in FBG levels by 64.7 ± 42.5 mg/dL at 1 day of IACI from baseline (P < .05). HbA1c ≥ 7% and HbA1c < 7% showed increases in FBG levels by 106.1 ± 49.0 mg/dL and 46.5 ± 3.8 mg/dL, respectively, at 1 day of IACI from baseline (P < .05). In the presence and absence of insulin therapy, there were significant increases in them by 122.6 ± 48.7 mg/dL and 48.0 ± 20.4 mg/dL, respectively, at 1 day of IACI from baseline (P < .05). But there were decreases in them to baseline levels at 2 days of IACI.Clinicians should consider the possibility of hyperglycemia when using corticosteroids for relief of musculoskeletal pain in Korean veterans from the US-Vietnam War who had a history of exposure to AO.
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Affiliation(s)
- Pa Hong
- Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon
| | - Yun Gyu Song
- Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon
| | - Sungwoo Paek
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
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Tamrakar M, Kharel P, Traeger A, Maher C, O'Keeffe M, Ferreira G. Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017. BMJ Glob Health 2021; 6:bmjgh-2021-005847. [PMID: 34001521 PMCID: PMC8130740 DOI: 10.1136/bmjgh-2021-005847] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Completeness of Global Burden of Disease (GBD) Study data is acknowledged as a limitation. To date, no study has evaluated this issue for low back pain, a leading contributor to disease burden globally. Methods We retrieved reports, in any language, based on citation details from the GBD 2017 study website. Pairs of raters independently extracted the following data: number of prevalence reports tallied across countries, age groups, gender and years from 1987 to 2017. We also considered if studies enrolled a representative sample and/or used an acceptable measure of low back pain. Results We retrieved 488 country-level reports that provide prevalence data for 103 of 204 countries (50.5%), with most prevalence reports (61%) being for high-income countries. Only 16 countries (7.8%) have prevalence reports for each of the three decades of the GBD. Most of the reports (79%) did not use an acceptable measure of low back pain when estimating prevalence. Conclusion We found incomplete coverage across countries and time, and limitations in the primary prevalence studies included in the GBD 2017 study. This means there is considerable uncertainty about GBD estimates of low back pain prevalence and the disease burden metrics derived from prevalence.
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Affiliation(s)
- Mamata Tamrakar
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Priti Kharel
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Adrian Traeger
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Maher
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mary O'Keeffe
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Giovanni Ferreira
- Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
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Prevalence of Rheumatic Diseases and Quality of Life in the Saraguro Indigenous People, Ecuador: A Cross-sectional Community-Based Study. J Clin Rheumatol 2021; 26:S139-S147. [PMID: 31415477 DOI: 10.1097/rhu.0000000000001131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Rheumatic diseases are more prevalent and aggressive in indigenous population groups, providing medical attention for which poses a challenge for the rheumatologist. OBJECTIVE To estimate the prevalence of musculoskeletal (MSK) disorders and rheumatic diseases in the Saraguro indigenous people in Ecuador, as well as to identify the main factors associated with the health status of this population. METHODS This observational, cross-sectional study focused on the community was conducted using the COPCORD (Community-Oriented Program for Control of Rheumatic Diseases) methodology. The required data were obtained using the following instruments: (1) a screening for MSK disorders and rheumatic diseases; (2) a sociodemographic questionnaire; (3) a functional capacity Health Assessment Questionnaire Disability Index questionnaire; and (4) the quality of life EQ-5D-3L (EuroQoL) questionnaire. The rheumatologists working with the indigenous community were responsible for examining and treating study participants suffering from MSK disorders. RESULTS The study sample comprised 2687 individuals, with mean age of 44 (SD, 19.9) years, 1690 (62.9%) of whom were women; Kichwa speakers comprised 32.4% (872), and 1244 (46.3%) reported MSK pain. The most prevalent conditions were as follows: low back pain (9.3%), hand osteoarthritis (OA, 7.2%), knee OA (6.5%), rheumatic regional pain syndrome (5.8%), fibromyalgia (1.8%), and rheumatoid arthritis (1.3%). Lower education level, unemployment, cooking with firewood, and rheumatic diseases were associated with a lower quality of life. CONCLUSIONS Musculoskeletal disorders, rheumatic diseases, and rheumatoid arthritis were found to be highly prevalent in the studied population. Rheumatoid arthritis and hand OA had the most significant impact on the quality of life.
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Gómez-Galán M, Callejón-Ferre ÁJ, Díaz-Pérez M, Carreño-Ortega Á, López-Martínez A. Risk of musculoskeletal disorders in pepper cultivation workers. EXCLI JOURNAL 2021; 20:1033-1054. [PMID: 34267615 PMCID: PMC8278212 DOI: 10.17179/excli2021-3853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 11/10/2022]
Abstract
Agricultural workers have an increased risk of musculoskeletal disorders, mainly due to the manual nature of the work. This study assesses the level of physical well-being in pepper cultivation workers in Almería (Spain). The objective was to analyze pepper cultivation tasks performed in the Almería-type greenhouse, using the OWAS (Ovako Working Posture Assessment System) and RULA (Rapid Upper Limb Assessment) methods. The OWAS results showed a normal posture percentage of 53 %, a medium risk of 30 %, a high risk of 16 %, and a very high risk of 1 %. The body areas most affected were the back and legs. The RULA assessment found high risk/action levels, with 50 % of the postures corresponding to level 3, 35 % to level 4, and 15 % to level 2. Improvements are therefore proposed; these include: redesigning tasks, mechanization, training, team development, and improving the workers' physical condition. The OWAS and RULA data may have overestimated the results, as workers do not appear to be limited in performing tasks and do not normally request sick leave.
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Affiliation(s)
- Marta Gómez-Galán
- CIMEDES Research Center (CeiA3), Department of Engineering, University of Almería, Ctra. Sacramento, s/n La Cañada, 04120 Almería, Spain.,Laboratory-Observatory of Andalusian Working Conditions in the Agricultural Sector (LASA), Avda. Albert Einstein, 4. Isla de la Cartuja, 41092 Seville, Spain
| | - Ángel-Jesús Callejón-Ferre
- CIMEDES Research Center (CeiA3), Department of Engineering, University of Almería, Ctra. Sacramento, s/n La Cañada, 04120 Almería, Spain.,Laboratory-Observatory of Andalusian Working Conditions in the Agricultural Sector (LASA), Avda. Albert Einstein, 4. Isla de la Cartuja, 41092 Seville, Spain
| | - Manuel Díaz-Pérez
- CIMEDES Research Center (CeiA3), Department of Engineering, University of Almería, Ctra. Sacramento, s/n La Cañada, 04120 Almería, Spain
| | - Ángel Carreño-Ortega
- CIMEDES Research Center (CeiA3), Department of Engineering, University of Almería, Ctra. Sacramento, s/n La Cañada, 04120 Almería, Spain
| | - Alejandro López-Martínez
- CIAMBITAL Research Center (CeiA3), Department of Engineering, University of Almería, Ctra. Sacramento, s/n La Cañada, 04120 Almería, Spain
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11
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Sharma S, Blyth FM, Mishra SR, Briggs AM. Health system strengthening is needed to respond to the burden of pain in low- and middle-income countries and to support healthy ageing. J Glob Health 2021; 9:020317. [PMID: 33274068 PMCID: PMC7680638 DOI: 10.7189/jogh.09.020317] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Saurab Sharma
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.,Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Fiona M Blyth
- Concord Clinical School Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | | | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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12
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Abstract
PURPOSE OF THE REVIEW To highlight the current challenges in diagnosis and clinical care of pediatric rheumatic disease and barriers to research and education of pediatric rheumatologists worldwide. RECENT FINDINGS Recent studies and reports demonstrate a paucity of studies on epidemiology, outcomes, and management guidelines from many regions of the world. There have been noteworthy efforts to bridge the gap in under resourced areas. An analysis of the global burden of rheumatic disease has demonstrated that while understudied, musculoskeletal diseases are prevalent and increasingly contribute to loss of years of healthy life. In juvenile idiopathic arthritis, two milestone publications in global pediatric rheumatology have recently been published. An international study evaluated the epidemiology, treatment, and outcomes of juvenile idiopathic arthritis and demonstrated global diversity in both clinical manifestations and outcomes. Notably, the first guidelines for managing pediatric rheumatic disease in a less resourced setting have been published for juvenile idiopathic arthritis. This document offers the first publication targeted to address challenges faced by pediatric rheumatology caregivers in low-resourced settings. These documents serve as exemplars for international collaboration in pediatric rheumatology and can be used as models for other pediatric rheumatic disease research. Other efforts are making progress in various arenas towards increasing access to care, education, and training in pediatric rheumatology. SUMMARY The global burden of rheumatic disease in the pediatric population is poorly understood but unrecognized disease greatly impacts the overall morbidity and mortality in this population. More studies in lesser resourced regions are needed to prioritize access to pediatric rheumatology care and prioritize a further increase in research capacity and education moving forward.
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13
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Ferreira GE, Buchbinder R, Zadro JR, O'Keeffe M, Kharel P, Carballo-Costa L, Oliveira J, Maher CG. Are musculoskeletal conditions neglected in national health surveys? Rheumatology (Oxford) 2021; 60:4874-4879. [PMID: 33493285 DOI: 10.1093/rheumatology/keab025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/04/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To describe the proportion of national health surveys that contained questions on the prevalence and consequences of musculoskeletal conditions. METHODS We used a comprehensive search strategy to obtain national health surveys from the 218 countries listed by the World Bank. Two authors independently extracted information from each national health survey. Outcomes were the proportion of surveys that: (i) contained questions on the prevalence of musculoskeletal conditions using the Global Burden of Disease categorisation of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, gout and other; (ii) contained condition-specific questions about activity limitation, severity of pain, and work absence. We also measured how frequently prevalence of low back pain was measured using a consensus-based standard definition for low back pain prevalence studies. RESULTS We identified national health surveys from 170 countries. Sixty-two (36.4%), the majority from high-income countries (N = 43), measured prevalence of at least one musculoskeletal condition. Osteoarthritis (53, 85.4%), low back pain (39, 62.9%) and neck pain (37, 59.7%) were the most commonly measured, while rheumatoid arthritis and gout prevalence were only measured in 10 (5.9%) and 3 (1.8%) surveys, respectively. A minority of surveys assessed condition-specific activity limitation (6, 3.6%), pain severity (5, 2.9%) and work absence (1, 0.6%). Only one survey used the consensus-based standard definition for low back pain. CONCLUSION Musculoskeletal conditions are being neglected in the majority of national health surveys. Monitoring musculoskeletal conditions through ongoing surveys is crucial for the development and evaluation of health policies to reduce their burden.
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Affiliation(s)
- Giovanni E Ferreira
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, Sydney, Australia
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Joshua R Zadro
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, Sydney, Australia
| | - Mary O'Keeffe
- Institute for Musculoskeletal Health, Sydney, Australia
| | - Priti Kharel
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, Sydney, Australia
| | - Lidia Carballo-Costa
- Department of Physiotherapy, Medicine and Biomedical Sciences, Universidade da Coruña, Faculty of Physiotherapy, Coruña, Spain
| | - Juliana Oliveira
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, Sydney, Australia
| | - Christopher G Maher
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Institute for Musculoskeletal Health, Sydney, Australia
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14
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Johnson D, Santos E, Kim K, Ponzini MD, McLennan YA, Schneider A, Tassone F, Hagerman RJ. Increased Pain Symptomatology Among Females vs. Males With Fragile X-Associated Tremor/Ataxia Syndrome. Front Psychiatry 2021; 12:762915. [PMID: 35126193 PMCID: PMC8811376 DOI: 10.3389/fpsyt.2021.762915] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/27/2021] [Indexed: 12/12/2022] Open
Abstract
Individuals with the fragile X premutation report symptoms of chronic pain from multiple systems, have increased incidence of comorbid conditions where pain is a prominent feature, and pathophysiology that supports disrupted pain regulation, inflammation, and energy imbalance. Less is known about how pain manifests for the subpopulation of carriers that develop the motor and cognitive changes of fragile X-associated tremor and ataxia syndrome (FXTAS), and how pain may differ between men and women. We gathered data collected from 104 males and females with FXTAS related to chronic pain, comorbid conditions related to pain, and medications used for pain control to further explore the types of pain experienced and to better characterize how individuals with the fragile X premutation experience pain sensation across genders. We found that women experience significantly more pain symptoms than men, particularly allodynia (20 vs. 2.0%, p = 0.008), peripheral neuropathy pain (43.9 vs. 25.4%, p = 0.0488), migraine (43.9 vs. 14.5%, p = 0.0008), fibromyalgia (26.8 vs. 0%, p = 0.0071) and back pain (48.5 vs. 23.4%, p = 0.008). We found onset of peripheral neuropathy predicts the onset of ataxia (β = 0.63 ± 0.25, p = 0.019) and tremor (β = 0.56 ± 0.17, p = 0.004) across gender. Women also report significantly more anxiety (82.9 vs. 39.7%, p < 0.001), which has implications for ideal pain treatment. These pain symptoms need to be recognized in the medical history and treated appropriately, with consideration for overlapping comorbidities.
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Affiliation(s)
- Devon Johnson
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Ellery Santos
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Kyoungmi Kim
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States.,Division of Biostatistics, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Matthew D Ponzini
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States.,Division of Biostatistics, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Yingratana A McLennan
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Andrea Schneider
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States.,Department of Pediatrics, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Flora Tassone
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States.,Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Randi J Hagerman
- Medical Investigation of Neurodevelopmental Disorders Institute, School of Medicine, University of California, Davis, Davis, CA, United States.,Department of Pediatrics, School of Medicine, University of California, Davis, Davis, CA, United States
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15
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French HP, Deasy M, Gallagher R, O'Grady A, Doyle F. Prevalence of Hip or Groin Pain in Adolescents: A Systematic Review and Meta-Analysis. Pain Pract 2020; 20:792-811. [PMID: 32362057 DOI: 10.1111/papr.12907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 04/01/2020] [Accepted: 04/26/2020] [Indexed: 12/25/2022]
Abstract
Musculoskeletal pain is a common cause of pain in adolescence and can be an important predictor of future pain. The prevalence of hip or groin pain that could potentially affect different adolescent populations has not yet been systematically reviewed. This systematic review aimed to determine the prevalence of hip or groin pain in this population. Five electronic databases were searched until January 2019 for eligible studies that included males and females 13 to 19 years of age. Study selection, data extraction, and risk of bias assessments were completed by 2 independent researchers. Based on inclusion criteria, 8 population-based, 8 clinical, and 4 sports populations were included. Studies were conducted in Europe, North America, and Australia. The prevalence was dichotomized into "0 to 3 months" and "3 months and above." Meta-analyses were performed to estimate the prevalence from 0 to 3 months, and individual estimates were reported for studies of 3 months and above. The overall prevalence of hip or groin pain in all adolescents from 0 to 3 months was 12% (95% confidence interval [CI] 6%, 23%) based on 10 studies, and was 7% (95% CI 6%, 10%) based on 7 population studies. Caution should be applied to these estimates due to substantial study heterogeneity. The pain prevalence in cerebral palsy from 0 to 3 months based on 4 studies was 13% (95% CI 10%, 15%). Individual prevalence estimates were 6% and 31% in obese and 4% in hypermobility populations, respectively, and ranged from 6% to 100% in 4 sports studies. The validity of these estimates is compromised by poor methodological quality.
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Affiliation(s)
| | - Margaret Deasy
- Physiotherapy Department, Sports Surgery Clinic, Santry, Dublin, Ireland
| | | | | | - Frank Doyle
- Royal College of Surgeons in Ireland, Dublin, Ireland
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16
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Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:299. [PMID: 32355743 PMCID: PMC7186678 DOI: 10.21037/atm.2020.02.175] [Citation(s) in RCA: 631] [Impact Index Per Article: 157.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Low back pain (LBP) is a common musculoskeletal problem globally. Updating the prevalence and burden of LBP is important for researchers and policy makers. This paper presents, compares and contextualizes the global prevalence and years lived with disability (YLDs) of LBP by age, sex and region, from 1990 to 2017. Methods Data were extracted from the GBD (the Global Burden of Disease, Injuries, and Risk Factors Study) 2017 Study. Age, sex and region-specific analyses were conducted to estimate the global prevalence and YLDs of LBP, with the uncertainty intervals (UIs). Results The age-standardized point prevalence of LBP was 8.20% (95% UI: 7.31–9.10%) in 1990 and decreased slightly to 7.50% (95% UI: 6.75–8.27%) in 2017. The prevalent numbers of people with LBP at any one point in time in 1990 was 377.5 million, and this increased to 577.0 million in 2017. Age-standardized prevalence of LBP was higher in females than males. LBP prevalence increased with age, and peaked around the ages of 80 to 89 years, and then decreased slightly. Global YLDs were 42.5 million (95% UI: 30.2 million–57.2 million) in 1990 and increased by 52.7% to 64.9 million (95% UI: 46.5 million–87.4 million) in 2017. YLDs were also higher in females than males and increased initially with age; they peaked at 35–39 years of age in 1990, before decreasing, whereas in 2017, they peaked at 45–49 years of age, before decreasing. Western Europe had the highest number of LBP YLDs. Conclusions Globally, LBP is the leading global cause of YLDs. Greater attention is urgently needed to mitigate this increasing burden and the impact it is having on health and social systems.
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Affiliation(s)
- Aimin Wu
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Lyn March
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Surveillance Task Force, Global Alliance for Musculoskeletal Health (G-MUSC), Sydney, Australia
| | - Xuanqi Zheng
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Jinfeng Huang
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Xiangyang Wang
- Division of Spine Surgery, Department of Orthopaedics, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou 325027, China
| | - Jie Zhao
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai 200011, China
| | - Fiona M Blyth
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW Australia
| | - Emma Smith
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney & Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Damian Hoy
- Institute of Bone and Joint Research, The University of Sydney & Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Surveillance Task Force, Global Alliance for Musculoskeletal Health (G-MUSC), Sydney, Australia
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17
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System strengthening to support value-based care and healthy ageing for people with chronic pain. Pain 2019; 160:1240-1244. [DOI: 10.1097/j.pain.0000000000001526] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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