Descriptive Analysis of an Interdisciplinary Musculoskeletal Program

BACKGROUND: Interdisciplinary musculoskeletal programs address comorbidities confounding musculoskeletal conditions and serve as an alternative to the single provider model. OBJECTIVE: Descriptive analysis of an interdisciplinary musculoskeletal program. DESIGN: •Retrospective descriptive analysis of patients enrolled in an interdisciplinary musculoskeletal program. •Retrospective Sub-Analysis: cohort of patients enrolled in interdisciplinary program with low back pain compared to historical cohort of patients in a single provider clinic. SETTING: Academic interdisciplinary musculoskeletal health program PATIENTS: Patients referred to program with at least one follow up visit over a two-year period. INTERVENTIONS: Interdisciplinary musculoskeletal program involving physiatry, pain anesthesia, nutrition, psychology, rheumatology, sleep medicine, nursing and physical therapy. OUTCOME MEASURES: Patient Specific Functional Scale (PSFS), Oswestry Low Back Disability Index (ODI), number of MRIs, CTs, opioid prescriptions; Press Ganey scores. RESULTS: •One hundred seventy three patients were enrolled and had at least one follow up visit. Twenty-four percent of patients with any musculoskeletal complaint demonstrated clinically significant improvements in total PSFS. Mean improvement in PSFS was + .864 (SD 1.94) which was a statistically significant improvement (p=.0005), but not clinically significant. •Five percent of patients were ordered MRIs and no CT scans were ordered. Six percent of patients received opioid prescriptions. •Press Ganey scores: 96% percent responded favorably in regards to physician communication quality, 86% of patients responded favorably for access to care, and 78% responded favorably for care coordination. •27.8% of patients with low back pain in the interdisciplinary program achieved a significant decrease in their ODI, compared to 26.6% in the single provider clinic (p=.87). CONCLUSIONS: Interdisciplinary musculoskeletal programs are a promising model to improve the functioning of patients with musculoskeletal pain and decrease downstream utilization. These programs may be more appropriate for patients at higher risk of developing chronic pain. LEVEL OF EVIDENCE: III Retrospective Review.