Healthcare-seeking and work outcomes in adults with common, non-inflammatory musculoskeletal diseases
We currently know little about how to support the transition from school to post-school occupations for young people with chronic pain conditions. This research seeks to build an evidence base to ground future research in this area
Musculoskeletal (MSK) disorders are a leading, and growing, cause of disability constituting a major component of primary care workload. They make a significant contribution to decreased work productivity and reduce the number of years that adults can expect to stay healthy and in work (i.e. characterised by healthy work life expectancy). The impact on work is further evidenced by an employment gap, with lower rates of employment for those with MSK disorders compared to those without.
With projected increases in the number of workers with multiple health conditions delaying retirement (due to shrinking retirement resources), robust observational evidence is needed to better inform the development of interventions aimed at sustaining productive employment for people with the most common MSK disorders. There is a specific need to focus on the older working population to understand the transitions from participating in work and the levels of participation to “out of work”.
Background
Across all working ages a small proportion of people who go on to long-term absence make up the majority of the costs associated with absence from the workplace. However, and particularly for those with MSK pain, there is currently no way of predicting which employees will return to work quickly without additional vocational advice and support, which employees will require this support and what levels of support are most appropriate. Consequently there is no way of ensuring the right individuals are directed towards the right services to support their occupational health needs.
There is a growing evidence base around stratified care approaches to delivering healthcare, but this approach has not yet been developed in occupational healthcare to test whether stratified care according to prognosis (estimated risk of poor outcome- defined as duration of work absence) can be successful in reducing this work absence.
Aims
The aim of this work is to characterise adults with MSK disorders who are at risk of work absence and reduced healthy working life expectancy.
The study’s main objectives are to:
Curate a large observational and clinical trial data resource including primary care/population studies with patient-reported measures of musculoskeletal health and work
Investigate prior patterns of care-seeking in those who exit the workforce early with MSDs
Contribute novel, policy-relevant population indicators, such as healthy working life expectancy, to the public health research theme.
What will this research involve?
We will bring together combined population cohort data and meta-data from the PRELIM, PRELIM Pilot, and HILL studies (combining over 18,000 participants), before harmonising and pooling this information, before submitting it to an open access repository (Keele Data Repository). Colleagues at University of Southampton will provide derived variables on occupational class and job exposure matrix.
This data will then be used to analyse work outcomes both in the general population and in people consulting with primary care for musculoskeletal conditions to see what relationships (if any) exist between patterns of care seeking and reduced health working life expectency.
What has the study found so far?
Keele-held observational data have now been pooled, harmonised and deposited. Occupational class and job exposure matrix variables have been derived and added. Analyses are now underway, and we hope to be able to announce any key findings from these in the near future.
Healthy Working Life Expectancy (HWLE), defined as the average number of years that people are healthy and working from age 50, has been operationalised. Currently, HWLE in England is 9.42 years from age 50. Key results from the papers listed below are that HWLE is lower for people with osteoarthritis and varies by sociodemographic factors (for example, HWLE was lower in women and those living in more deprived areas), health factors, and workplace factors.
Papers referenced
Lynch M, Bucknall M, Jagger C, Wilkie R. Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations. Scientific Reports (2022) Feb 14;12(1):2408.
Lynch M, Bucknall M, Jagger C, Wilkie R. Projections of healthy working life expectancy in England to the year 2035. Nature Aging (2022) 2; 13-18.
Parker M, Bucknall M, Jagger C, Wilkie R. Population-based estimates of healthy working life expectancy in England at age 50 years: analysis of data from the English Longitudinal Study of Ageing. Lancet Public Health (2020) Jul;5(7):e395-e403.
Study team
Chief investigator
Dr Ross Wilkie (Keele University)
Co-investigators
Dr Dahai Yu (Keele University)
Professor George Peat (Keele University)
Professor Gwenllian Wynne-Jones (Keele University)
Dr Elaine Wainwright (University of Aberdeen)
Dr Nicola Goodson (University of Liverpool)
Associated research staff
Dr Marty Lynch (Keele University)
Centre institutions
Further information
If you have any queries about this research including requests for data access, please contact ross.wilkie@keele.ac.uk