The  Norwegian  BJD  NAN  

”Making  MSCs  a  research  priority  in  Norway”    

Jakob  Lothe  D.C.      Chair  MST  Norway  and  President  Norwegian  Chiropractors’  Associa@on  

   

Norway  in  a  nutshell  

•  5  million  inhabitants  •  Norway  again  top  rated  in  UNDP  Human  Development  Index  2014    

•  Highly  developed  health  services  and  educaGon  system  based  on  the  principle  of  equality  

•  MSD  tremendous  burden  and  cost:  –  40  %  of  sick  leave  days  –  30  %  of  all  disability  costs  –  Total  costs  represents  8  %  of  total  Fiscal  Budget  

 

MST  (NAN  Norway)  •  Established  2003  •  Non-­‐commercial  organizaGon  independent  of  sponsors    •  Source  of  income  solely  organisaGon/insGtuGon  membership  

dues  and  conference  profit  –  1.000  Euros/1.250  USD  per  year  per  organisaGon  

•  Part-­‐Gme  in-­‐house  Secretariat  at  FORMI/Oslo  University  Hospital  

Member  organizaGons:  

1.  Norwegian  Directorate  of  Health  2.  NaGonal  InsGtute  of  OccupaGonal  Health  3.  FORMI:  The  CommunicaGon  Unit  for  MSC    

4.  Norwegian  RheumaGsm  AssociaGon  5.  Norwegian  Osteoporosis  AssocaGon  6.  Norwegian  Back  Pain  AssociaGon    7.  Norwegian  AssociaGon  for  Women  with  Pelvic  Pain  

8.  Norwegian  AssociaGon  of  Rheumatologists  9.  Norwegian  Orthopedic  Society  10.  Norwegian  ChiropracGc  AssociaGon  11.  Norwegian  Physiotherapy  AsssociaGon  12.  Norwegian  Society  of  Psychomotor  Physiotherapy  

MSTs’  Two  Major  Projects:  

•  A  comprehensive  report  on  the                                        costs  and  burden  of  MSCs  in  Norway  – Released  May  2013  

•  Making  MSCs  a  research  priority  in  Norway  – Today’s  theme  – A  success  story  •  These  two  apparently  separate  projects  are  closely  related  and  taught  us  the  same  lesson  

–  Why?  

 

Who  are  we?    

Who  do  we  represent?    

What  is  our  field  of  interest?    

What  do  we  want?    

What  is  achievable?    

BOTH  projects  raised  the  SAME  fundamental  quesGons  !  that  applies  to  most  of  you  I  would  think  J  

AND  THE  FINAL  BIG  Q:  What  is  MSC?  IdenGfying  the  need  for  definiGons  and  consensus  

– What  are  the  diagnosGc  boundaries  of  MSC?  •  an  absolute  necessity  to  be  able  to:  

–  esGmate  costs  and  burden  –  define  the  scope  of  a  research  priority  

•  stakeholders  need  to  know  in  order  to  take  acGon  –  In  the  beginning  we  got  as  many  answers  as  members  on  the  board!  

–  Long  and  thorough  board  discussions  –  Since  no  one  else  knew  in  Norway,  we  had  to  arrive  at  consensus  on  our  own  definiGon  -­‐  MUSSP!  •  inspired  and  compaGble  with  the  BJD  framework  J  •  we  included  MS  trauma,  -­‐diseases  AND  -­‐complaints  •  we  adapted  the  BJD-­‐concept  of  musculoskeletal  health  

             

 

 

MUSSP  Musculoskeletal  Health  includes  trauma,  diseases  aand  complaints  in  the  musculoskeletal  system  (MUSSP)  and  is  divided  into  5  major  groups:  1.  Pain  and  other  complaints  and/or  altered  funcGon  in  the  

musculoskeletal  system  caused  by  physical  and  psychological  stress    

2.  Non-­‐infecGous  inflammatory  disease  of  the  joints,  spine  and/ord  soj  Gssues  

3.  DegeneraGve  disease    of  the  joints  and/or  spine  4.  Pathological  bone  loss/osteoporosis  with  or  without  

fractures  5.  Trauma  to  the  musculoskeletal  system  and  its  long  term  

health  consequences    

Our  3  keys  to  success:  

1.  Clear  definiGon  of  our  scope  of  interest  and  field  of  competency  –  idenGty    

2.  Broad  composiGon  of  member  organisaGons/insGtuGons  that  is  representaGve  of  our  mission  -­‐  legiGmacy  

3.  Saying  no  to  any  commercial  sponsorship  gives  independence  -­‐  credibility    

RESULT:  Perceived  as  ONE  VOICE  in  the  receiving  end:  PoliGcians  and  stakeholders!    

Achievements  so  far:  

•  Our  report  has  been  widely  referred  to  and  received  much  publicity  resulGng  in:  –  Increased  awareness  of  costs  and  burden  of  MSCs  –  Clear  definiGons  place  and  address  responsibility  towards  stakeholders  and  poliGcians  

•  Our  definiGons  and  esGmates  (MUSSP)  has  now  been  adapted  in  the  2014  Norwegian  Public  Health  Report    

•  Establishment  of  The  Norwegian  MSC  research  priority  (MUSS)  

MUSS  

•  MST  was  instrumental  in  the  iniGaGon  of  MUSS:  – MST  provided  the  “neutral”  ground  and  gave  arena  for  a  “new  beginning”  to  restart  previous  anempts  that  had  failed  due  to  conflicts  and  lack  of  consensus  among  researchers.  

– MST  acGvely  guided  and  conducted  a  consensus  process  among  research  stakeholders.  

– MST  gave  input  to  ensure  that  key  elements  like  research  in  primary  care  and  paGent  parGcipaGon  was  included  in  a  MUSS  mission  statement  that  later  was  adapted  

•  The  MUSS  mission  statement  reflects  the  scope  of  the  MST  cost  and  burden  report  

ImplicaGons  of  MUSS:  •  The  establishment  of  MUSS  means  prioriGzaGon  in  government  funding  and  commitment  to  a  naGonal  research  strategy  and  networking  to  all  parGcipaGng  parGes  (universiGes,  hospitals  and  other  research  bodies)  

•  MUSS  clearly  defines  an  area  of  research  embodied  as  a  naGonal  priority  

•  MUSS  provides  a  clear  address  for  future  funding  and  poliGcal  support/iniGaGves  

•  Previous  fragmentaGon  is  now  being  replaced  with  congregaGon  of  research  acGviGes,    inclusion  of  primary  care  and  paGent  parGcipaGon  

 “United  we  stand  –  divided  we  fall”  

 •  Please  visit  our                                                                                                    MST  Poster  for  more                                                    informaGon!  

•  www.mst.no    

•  Thank  you  very  much                                                                              fo                      for  your  anenGon!                                                              anenGon!                                  

2014 BJD World Network Conference 12-13th October, London, UK

4) Key Development Plan for 2014 and Beyond

3) Key Interactions that engage the broader musculoskeletal community, e.g. other professions, all stakeholders, other countries

2) Key Activities to raise priority at a political level for musculoskeletal conditions

1)   Key Projects in 2013/2014 •  The national research collaboration network MUSS arranged it’s second national

research conference in November 2013 that was well attended. BJD Chair Tony Woolf was invited as keynote speaker and also held a separate session to the MUSS steering group. With the establishment of MUSS, musculoskeletal research has become the 5th disease area declared as a national priority within the universities and hospitals. Having played an active role in the establishment of MUSS, MST has continued to actively co-participate in MUSS’ activities since. Our efforts has resulted in a formalized collaboration and definition of roles between MUSS and MST. The next national conference in November 2014 will have more emphasis on patient participation and advocacy, and MST is partly responsible for those sections and will also have its’ own presentation in the main programme.

2) Key Activities to raise priority at a political level •  MST continues to disseminate our “Cost and Burden”-report published May 2013. A

summary in English is now included in the report. The report has undoubtedly raised the political priorities and has been presented to several MPs.

•  In a new Public Health-report from The National Institute of Public Health, musculoskeletal disorders is given a separate comprehensive chapter that to a large degree is based on the MST-report and the GBD-reports. It also seems that the BJD-concepts and –definitions of “Musculoskeletal Health” now is started to be used in reports and planning documents

•  MST has been invited in by the Government to give input to two new White Papers on Public Health and Primary Health Care. We have participated in meetings and give written input to the Health Department.

3) Key Interactions that engage the broader musculoskeletal community •  Our member organisation Norwegian Back Pain Patient Association will celebrate it’s

20th anniversary in on World Spine Day, October 16th, by arranging a one-day conference together with MST in the Directorate of Health in Oslo.

4) Key Development Plan for 2015 and Beyond •  A new action plan for 2015-2020 is close to completion after long in-depth board

discussions. By setting out for ambitious, but still realistic goals, we aim to develop MST into a sustainable organisation capable on taking on activities like national fund-raising campaigns and international events within 2020.