Disability of Musculoskeletal Origin in Community-dwelling Elderly

Disability of Musculoskeletal Origin in Community-dwelling Elderly: Efficacy of a Specific Clinical Intervention.

Objectives: To assess the efficacy of an intervention program targeted to the elderly with recent-onset disability of musculoskeletal origin (DIMS), and to perform its economic evaluation.

Methodology: 1) Controlled randomised intervention study (3 years). Subjects: persons older than 65 in health district 7 of Madrid with acute (< 3 months) DIMS. Intervention group patients will be attended by rheumatologists acording with clinical (diagnostic and therapeutical) protocols. Control group will receive the routine attention from the Health System. Efficacy and costs variables will be collected through monthly structured telephone interviews performed by independent personnel blinded to the intervention group. Efficacy will be measured by differences between groups regarding: 1) time to improvement in the baseline DIMS episode, 2) number of subsequent DIMS, and 3) total number of DIMS days. An economic evaluation will be performed from a societal perspective.

Inclusion Criteria:

• Diagnosis of Musculoskeletal disorder

• Older than 64 years

• To have disability measured with a) or b):

  1. Rosser clasification: at least 4.
  2. M.Gill questionnaire: To need help from other person to dress, to tidy up itself, to walk or to stand up.

• Disability of recent onset:less than three months.(Patiens had a better functional situation before)

Exclusion Criteria:

• Recent surgery
• Dementia with no family support
• Institutionalized