What is the Early Intervention Toolkit designed to do? How does it work?
Dr. Juan Jover: We’ve known for a long time that in cases of aggressive autoimmune diseases it’s important to identify the patients and treat them effectively very early in the disease course in order to avoid future disability. In the last 25 or 30 years, health systems have developed specific care pathways for early treatment and the method has been very successful for the more aggressive diseases.
We wanted to see if the same approach could help patients suffering from more frequent, less aggressive but still debilitating diseases. In less aggressive diseases, you cannot act early in the disease because you would need to treat forty percent of the population, which is impossible. But when a patient has an episode of disability due to lower back pain or tendonitis you have a chance to treat them. And it turns out that if you treat an episode of disability very early, you change the course of that patient, because the episode of disability is shorter and the patient doesn’t end up with a long-term disability.
If you analyse a country, a region or a city, you can confidently predict how many episodes of work disability will occur. The number will be the same from one year to the next. So it’s very easy to plan ahead and to offer to workers early intervention programmes.
That’s what the toolkit is about, helping healthcare systems reduce disability rates by treating patients with short term work disability quickly and effectively.
Why are musculoskeletal disease rates so stable and predictable?
JJ: Populations don’t change radically from one year to another. If you analyze the data on disability, there are always two main causes in the working age populations: musculoskeletal diseases and mental illnesses. The good news is that these forms of disability can be reversed with the right treatment at the right moment.
The concept is very simple. Don’t focus on specific diseases: there are more than 200 diseases that fall under the umbrella of musculoskeletal disorders. You have to focus instead of episodes of disability. Because the idea is to get people back to their lives. If they work, we want to get them back to work. If they’re retired, we want them to have a high quality of life and be able to go out, be able to be with friends and family rather than stuck at home because they are unable to walk.