Are musculoskeletal conditions neglected in national health surveys?

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.

Neck pain care pathways and costs: association with the type of initial contact health care provider. A retrospective cohort study

“…Like LBP, for individuals with NP, there appears to be an opportunity to identify strategies and tactics to make it easier for individuals to obtain non-pharmacologic services through either selection of an initial contact HCP, or timely referral from primary care and specialist HCPs. ) 4 (0, 36) 0 (0, 0) 0 (0, 2) 0 (0, 0) 28 (0, 56) All 0 (0, 0) 0 (0, 0) 0 (0, 5) 0 (0, 2) 0 (0, 7) 0 (0, 0) 38 (6, 98) OS 14 (6,36) 41 (12,104)…”

“…Annual United States (US) all-payer combined NP and low back pain (LBP) costs are estimated to be $134.5 billion, making spinal disorders the costliest condition type, more than all other musculoskeletal conditions combined ($129.8 billion) and more than the cost of diabetes ($111.2 billion) 3 . NP estimated years lived with disability (YLD) is also high 1,4 , although YLD estimates may over or underrepresent actual NP disability [5][6][7] .…”

Health systems strengthening to arrest the global disability burden: empirical development of prioritised components for a global strategy for improving musculoskeletal health

“…This observation resonates with recent findings of limited inclusion of MSK conditions in population health surveys. 97 We infer this may be due to the strong representation of clinician panellists placing more emphasis on community engagement and service delivery components, compared with system-level actions like population health surveillance. Panellists from LMICs identified more components as ‘essential’ compared with panellists from high-income settings.…”

Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017

“…There is also a need to focus energies on parts of the world that have little or no LBP prevalence data. 10 A good example of a model is that adopted in the Solomon Islands 11 where the Global Alliance for Musculoskeletal Health Survey Module was included in the country’s national health survey. Another option would be to include the Musculoskeletal Health Survey Module in the WHO’s STEPs programme for non-communicable diseases.…”