Background/Problem. Musculoskeletal (MSK) conditions represent Australia’s highest disease burden, with 25% higher burden in rural regions. Access to appropriate care in these regions can be limited, leading to costly and unnecessary medical services (e.g., imaging, injections).
Purpose: This presentation describes a care pathway aimed at improving access to care for people with MSK conditions living in regional, rural and remote Australia (PACE-RURAL).
Methods: We followed a clinical translation framework to develop, adapt and scale a PAthway of CarE to be suitable for implementation in rural Australia. Key stakeholders (allied-health clinicians, patients, researchers and 15+ partner organisations) codesigned implementation strategies. We conceptualised PACE-RURAL in three steps.
Step1: Identify care needs using risk assessment at the point of care. We established the Short Form Örebro Musculoskeletal Pain Screening Questionnaire accurately identified people at risk of poor outcome.
Step 2: Provide people at low-risk access to guideline-based e-resources. We collaboratively designed a “one-stop shop” (www.mypainhub.com) for evidence-based resources for common MSK conditions (low back, neck, knee and hip pain), customised for patients and clinicians.
Step 3: Provide collaborative care with allied-health specialists for people at risk of poor outcome using telehealth. Allied-health specialists (e.g., specialist physiotherapists) provide collaborative care with primary health clinicians (as an alternative to medical referral). Building on positive feedback from implementation in urban regions, we will adapt PACE to include telehealth.
Outcome/conclusion: A comprehensive, robust pathway, with implementation strategies codesigned with key stakeholders, will now be tested in an Australia-wide hybrid type II effectiveness-implementation trial. Participant health outcomes and health care utilisation will be collected at baseline, 3, 6, and 12 months. Implementation outcomes will include feasibility, fidelity, reach, appropriateness, acceptance, adoption, and sustainability of the new pathway. Data will be collected via participant surveys and clinical audits.