abstract: 'Purpose

  To compare outcomes in employed people from an enhanced routine

  management pathway for musculoskeletal disorders within National Health

  Service Scotland with an existing active case-management system, Working

  Health Services Scotland.

  Materials and methods

  The study comprised a service evaluation using anonymised routinely

  collected data from all currently employed callers presenting with

  musculoskeletal disorder to the two services. Baseline demographic and

  clinical data were collected. EuroQol EQ-5D(TM) scores at the start and

  end of treatment were compared for both groups, overall and by age, sex,

  socio-economic status, and anatomical site, and the impact of mental

  health status at baseline was evaluated.

  Results

  Active case-management resulted in greater improvement than enhanced

  routine care. Case-managed service users entered the programme earlier

  in the recovery pathway; there was evidence of spontaneous improvement

  during the longer waiting time of routine service clients but only if

  they had good baseline mental health. Those most disadvantaged through

  mental health co-morbidity showed the greatest benefit.

  Conclusions

  People with musculoskeletal disorders who have poor baseline mental

  health status derive greatest benefit from active case-management.

  Case-management therefore contributes to reducing health inequalities

  and can help to minimise long-term sickness absence. Shorter waiting

  times contributed to better outcomes in the case-managed service.'
affiliation: 'Bergman, BP (Corresponding Author), Inst Hlth \& Wellbeing, Publ Hlth
  \& Hlth Policy, 1 Lilybank Gardens, Glasgow G12 8RZ, Lanark, Scotland.

  Bergman, Beverly P.; Lewsey, James; Macdonald, Ewan, Univ Glasgow, Inst Hlth \&
  Wellbeing, Glasgow, Lanark, Scotland.

  Demou, Evangelia, Univ Glasgow, MRC CSO Social \& Publ Hlth Sci Unit, Glasgow, Lanark,
  Scotland.'
author: Bergman, Beverly P. and Demou, Evangelia and Lewsey, James and Macdonald,
  Ewan
author-email: Beverly.bergman@glasgow.ac.uk
author_list:
- family: Bergman
  given: Beverly P.
- family: Demou
  given: Evangelia
- family: Lewsey
  given: James
- family: Macdonald
  given: Ewan
da: '2023-09-28'
doi: 10.1080/09638288.2021.1912837
earlyaccessdate: APR 2021
eissn: 1464-5165
files: []
issn: 0963-8288
journal: DISABILITY AND REHABILITATION
keywords: 'Musculoskeletal disorder; case management; intervention; sickness

  absence; rehabilitation; health inequalities'
language: English
month: AUG 14
number: '17'
number-of-cited-references: '31'
orcid-numbers: Demou, Evangelia/0000-0001-8616-525X
pages: 4648-4655
papis_id: 9155823b4c3d43f916e944b62aa0ac96
ref: Bergman2022comparisonroutine
researcherid-numbers: 'Lewsey, James/F-7546-2010

  '
times-cited: '0'
title: A comparison of routine and case-managed pathways for recovery from musculoskeletal
  disorders in people in employment
type: Article
unique-id: WOS:000643835900001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '44'
web-of-science-categories: Rehabilitation
year: '2022'