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Research Request – Definition of Early Intervention in health and rehabilitation

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FOI-24/25-0120

DOCUMENT 2

Research Request – Definition of Early Intervention in health and rehabilitation

Brief * Information on how ‘early intervention’ is defined in the context of a rehabilitation/treatment approach with adults with musculoskeletal conditions.
* For context, we described that “early intervention” is typically therapy supports provided early in a diagnosis, intended to reduce the long term functional impact or progress of the condition.
* The lawyers are seeking confirmation that this term is well known in the “industry” of health care and rehabilitation.
Date 12/08/19
Requester Shannon redacted: s47F - personal p & Susan redacted: s47F - personal p
Researcher Aanika redacted: s47F - personal p

Contents

Use of the term ‘early intervention’ and definitions …………………………………………………………………… 2

Definitions of early intervention in work injury space …………………………………………………………………. 3

Definitions of rehabilitation …………………………………………………………………………………………………….. 4

Relevant COAG APTOS passages …………………………………………………….. Error! Bookmark not defined.

Bibliography ………………………………………………………………………………………………………………………….. 5

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Use of the term ‘early intervention’ and definitions

The term ‘early intervention’ is frequently referred to in the health, mental health, rehabilitation and work cover (workplace injury) fields.

The Allied Health Professions Australia website states that:

  • Musculoskeletal conditions affect muscles, joints, nerves, soft tissues, tendons and ligaments are common in our community. All ages can be affected and the conditions may be acute, arising from injury or unaccustomed activity, or due to a long-term condition. Allied health practitioners are key to prevention, diagnosis, early intervention and treatment of injuries and pain and the ongoing management of chronic musculoskeletal conditions¹.

The Meriam-Webster dictionary defines early / intervene / musculoskeletal independently as²:

  • near the beginning of a period of time;

  • to interfere with the outcome or course especially of a condition or process (as to prevent harm or improve functioning);

  • of, relating to, or involving both musculature and skeleton.

In March 2014 – a European Steering Group (ESG) on Sustainable Healthcare was developed by pharmaceutical research company, which brings together expertise from the policy community, civil society, healthcare professionals, scientific societies, academics and industry. This group published a paper titled Acting Together: A Roadmap for Sustainable Healthcare. This paper highlighted the importance of prevention and early intervention stating that:

  • Prevention means intervening before something becomes a serious health issue, including eradicating, eliminating or minimising the impact of disease and disability or, if this is not feasible, slowing the progression of disease and disability. Early intervention, on the other hand, is the process of providing specialist intervention and support services for a person who needs them, either early in the life course or at the onset of the development of a health problem.³

Early Intervention is also often used in the context of children with developmental disabilities. The Royal Australasian College of Physicians states that:

  • Early intervention for children with developmental disabilities involves timely provision of an optimal nurturing and learning environment that aims to maximise developmental and health outcomes and reduce the degree of functional limitations.⁴

1 Australian Health Professions Australia, ‘Musculoskeletal health’, Allied Health Professions [website], 2019, https://ahpa.com.au/key-areas/musculoskeletal-health/ accessed 12 August 2019. 2Merriam Webster Dictionary [online], 2019, < https://www.merriam-webster.com/dictionary/early> accessed 13 August 2019. 3 AbbVie, ‘Acting Together: A Roadmap for Sustainable Healthcare’, European Steering Group 2015, https://www.abbvie.com/content/dam/abbviecorp/us/desktop/sustainablehealthcare/images/EU-Call-To-Action.pdf accessed 12 August 2019. 4 Paediatric and Child Health Division, ‘Positon Statement: Early Intervention for Children with Developmental Disabilities’, Royal Australasian College of Physicians [website], 2013, <https://www.racp.edu.au/docs/default-source/advocacy- library/early-intervention-for-children-with-developmental-disabilities.pdf> accessed 12 August 2019.

Early Intervention is also used in the mental health space. The Australian Commonwealth Department of Health states that:

  • People with an emerging mental health problem or mental illness will be identified and treated as early as possible in the initial phase and any subsequent episode, to minimise the severity and duration of the condition and to reduce its broader impacts [and] early intervention can reduce the impact of mental health problems and mental illness⁵.

In 1993 a controlled study of the effects of an early intervention on acute musculoskeletal pain problems was conducted by the Department of Occupational Medicine at the Orebro Medical Center in Sweden⁶.

  • The study demonstrated that early active physical therapy intervention for patients suffering their first episode of acute musculoskeletal pain significantly decreased the incidence of chronic pain.
  • In this study, injured workers complaining of acute musculoskeletal pain were either seen by a physical therapist within the first few days after injury or had to wait a week or more to be seen. Both groups were seen by a general practitioner to rule out aggressive disease or problems that might require medical treatment. Patients in the early intervention group saw a physical therapist within the first three days following their injury.
  • Of those people who were suffering their first episode of musculoskeletal pain who had early physical therapy intervention only 2% went on to develop chronic pain. Of those who did not get early intervention, 15% became chronic pain patients.

Definitions of early intervention in work injury space

In the Worksafe/cover space regarding musculoskeletal conditions and injuries, early intervention is often referred to as a prevention strategy when a health or safety risk has been identified, or an incident has occurred, and measures are consequently put in place to either prevent or reduce the impact of the risk⁷.

For example, Comcare (the workers compensation insurer for the Australian Government) states that:

  • Early intervention is about identifying and responding to warning signs and reports of accidents and incidents in the workplace…The earlier you notice a worker is experiencing potential signs of ill health or injury, the sooner you can take steps to help them⁸.

5 Australian Commonwealth Department of Health, National Mental Health Policy 2008: Early Intervention [website], 2009, <https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-pol08-toc~mental-pubs-n- pol08-2~mental-pubs-n-pol08-2-4> accessed 12 August 2019. 6 SJ Linton, AL Hellsing & D Andersson, ‘Department of Occupational Medicine, Orebro Medical Center, Sweden, vol.54, no. 3, 1993, pp. 353-9, https://www.ncbi.nlm.nih.gov/pubmed/8233552 accessed 13 August 2019. 7 Queensland Government, Workplace Health and Safety Electrical Safety Office Workers’ Compensation Regulator, ‘Early interventions for musculoskeletal disorders’, Workcover Queensland [website], 4 May 2017, https://www.worksafe.qld.gov.au/forms-and-resources/webinars/early-interventions-for-musculoskeletal-disorders accessed 12 August 2019. 8 Australian Government Comcare, ‘Early intervention’, 6 Jun 2014, <https://www.comcare.gov.au/early intervention> accessed 12 August 2019.

Comcare website also states that having Early Intervention Rehabilitation systems in place is important because:

  • Providing rehabilitation as soon as practicable after an injury or on the request of an injured employee sets an expectation of an early return to work. This reduces the human and financial costs associated with workers’ compensation claims or other forms of leave. It demonstrates that the employer values its employees⁹.

Considering that injury and musculoskeletal disorders led to 90% of serious work compensation claims in 2014–15, it makes sense that the concept of early intervention is closely aligned with the workplace¹⁰.

Definitions of rehabilitation

The Royal Australian College of Physicians definition of rehabilitation is:

“Rehabilitation Medicine is the diagnosis, assessment and management of an individual with a disability due to illness or injury. Rehabilitation physicians work with people with a disability to help them achieve an optimal level of performance and improve their quality of life”¹¹.

The National Health Data Dictionary, defines the rehabilitation classification and model of care as:

  • Care in which the primary clinical purpose or treatment goal is improvement in the functioning of a patient with an impairment, activity limitation or participation restriction due to a health condition. The patient will be capable of actively participating¹².

9 Australian Government Comcare, ‘Early intervention – early intervention rehabilitation systems in place [website]’ 4 Nov 2013, https://www.comcare.gov.au/ accessed 13 August. 10 Safe Work Australia, ‘Disease and injury statistics [website], 20 Sep 2018, <https://www.safeworkaustralia.gov.au/statistics-and-research/statistics/disease-and-injuries/disease-and-injury- statistics> accessed 13 Aug 2019. 11 Royal Australian College of Physicians, Australasian Faculty of Rehabilitation Medicine [website], 2019, https://www.racp.edu.au/about/college-structure/australasian-faculty-of-rehabilitation-medicine accessed 13 August 2019. 12 Australian Government Australian Institute of Health and Welfare Canberra, ‘Development of nationally consistent subacute and non-acute admitted patient care data definitions and guidelines’, 2013, https://www.aihw.gov.au/getmedia/01d815ba-3d66-48c9-a9ec-aaa5825c19f2/15425.pdf.aspx?inline=true accessed 12 August 2019.

Bibliography

AbbVie, ‘Acting Together: A Roadmap for Sustainable Healthcare’, European Steering Group 2015, https://www.abbvie.com/content/dam/abbviecorp/us/desktop/sustainablehealthcare/images/EU-Call-To-Action.pdf accessed 12 August 2019.

Australian Commonwealth Department of Health, National Mental Health Policy 2008: Early Intervention [website], 2009, https://www1.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-pol08-toc~mental-pubs-n-pol08-2~mental-pubs-n-pol08-2-4 accessed 12 August 2019.

Australian Government Australian Institute of Health and Welfare Canberra, ‘Development of nationally consistent subacute and non-acute admitted patient care data definitions and guidelines’, 2013, https://www.aihw.gov.au/getmedia/01d815ba-3d66-48c9-a9ec-aaa5825c19f2/15425.pdf.aspx?inline=true accessed 12 August 2019.

Australian Government Comcare, ‘Early intervention – early intervention rehabilitation systems in place [website]’ 4 Nov 2013, https://www.comcare.gov.au/ accessed 13 August.

Australian Government Comcare, ‘Early intervention’, 6 Jun 2014, <https://www.comcare.gov.au/early intervention> accessed 12 August 2019.

Australian Health Professions Australia, ‘Musculoskeletal health’, Allied Health Professions [website], 2019, https://ahpa.com.au/key-areas/musculoskeletal-health/ accessed 12 August 2019.

Linton SJ, Hellsing AL & Andersson D, ‘Department of Occupational Medicine, Orebro Medical Center, Sweden, vol.54, no. 3, 1993, pp. 353-9, https://www.ncbi.nlm.nih.gov/pubmed/8233552 accessed 13 August 2019.

Merriam Webster Dictionary [online], 2019, < https://www.merriam-webster.com/dictionary/early> accessed 13 August 2019.

Paediatric and Child Health Division, ‘Positon Statement: Early Intervention for Children with Developmental Disabilities’, Royal Australasian College of Physicians [website], 2013, https://www.racp.edu.au/docs/default-source/advocacy-library/early-intervention-for-children-with-developmental-disabilities.pdf accessed 12 August 2019.

Queensland Government, Workplace Health and Safety Electrical Safety Office Workers’ Compensation Regulator, ‘Early interventions for musculoskeletal disorders’, Workcover Queensland [website], 4 May 2017, https://www.worksafe.qld.gov.au/forms-and-resources/webinars/early-interventions-for-musculoskeletal-disorders accessed 12 August 2019.

Royal Australian College of Physicians, Australasian Faculty of Rehabilitation Medicine [website], 2019, https://www.racp.edu.au/about/college-structure/australasian-faculty-of-rehabilitation-medicine accessed 13 August 2019.

Safe Work Australia, ‘Disease and injury statistics [website], 20 Sep 2018, https://www.safeworkaustralia.gov.au/statistics-and-research/statistics/disease-and-injuries/disease-and-injury-statistics accessed 13 Aug 2019.