Experts agree on key policy recommendations for management, prevention of rheumatic, MSKD

On 19 October 2010, experts from academia, scientific societies, patient organisations, Member States' government and social security institutions as well as EU bodies agreed upon a number of key policy recommendations for improving the management and prevention of rheumatic and musculoskeletal diseases (MSKD). This set of recommendations, and specific initiatives for their implementation, were the main outcomes of the EU Presidency Conference on MSKD, organised in collaboration with EULAR, the European League Against Rheumatism. The recommendations embraced six areas of intervention: MSKD on health policy agendas; rights of patients to healthcare and to full inclusion in economic and social life; early prevention; evidence-based treatment and standards of care; patient involvement in the design, implementation and evaluation of healthcare services; and research. Conference recommendations culminated in the call for an EU Musculoskeletal Disease Strategy and national action plans.

Consensus was reached among participants concerning recognition of the socioeconomic importance of MSKD and the need for prioritising MSKD on health policy agendas. As EULAR President Prof. Paul Emery stated, "MSKD should be recognised as one of the most important public health challenges, given the enormous burden of these disorders on individuals' lives, the social and health systems, and thereby the whole economy".

The conference underlined the importance of active patient involvement. Access to health care services and full inclusion in society have to be recognised as entitlements of citizens with such disorders. However, as several speakers pointed out, much effort is still needed to guarantee equal access to treatment as well as integration into the labour market. Employers were called upon to allow for adaptations of work environments and working conditions. Such flexibility at work places would enable people to stay in work or return to work instead of being excluded.

Delegates also made the case for concrete actions on prevention. The impact of musculoskeletal diseases could in many cases be limited if people affected by them benefited from early referral and early diagnosis. Well trained general practitioners and specialists as well as a sufficient number of specialised centres, were mentioned as key elements to serve this purpose.

According to participants, EU institutions and Member States should guarantee that the management of chronic diseases, and particularly MSKD, is organised in accordance with evidence-based recommendations. Moreover, standards of care should be further developed and implemented across Europe.

Special attention was given to the role of patients in both prevention and management of musculoskeletal diseases. It was emphasized that patients should be more involved in the design, implementation and evaluation of healthcare services, and that new forms of doctor/patients partnership should be developed. Neil Betteridge, Vice President of the EULAR Standing Committee of People with Arthritis and Rheumatism in Europe (PARE), said: "The involvement of patients represents benefits in two different ways. First, it promotes self-management and self-sufficiency, which are essential for coping with our own diseases. Second, as we are experts in living with these conditions, we can make a significant contribution in designing and evaluating preventive initiatives and treatments".

Delegates also recognised the need for a stronger commitment of both Member States and EU institutions to support and fund basic and applied research in this area. It was stressed that it is not only important to improve knowledge on the determinants of these disorders, but also knowledge and technologies in the fields of prevention and treatment.

EULAR President Prof. Emery presented the conference recommendations at the Ministerial Conference "Innovative approaches for chronic illness in Public Health and Healthcare systems", organised by the Belgian EU Presidency on the following day. Summarising the two days, Prof. Emery declared: "Our community is very satisfied with the results of these two conferences. We can see that Europe is finally recognising the dimension and impact of musculoskeletal disorders. All actors should now work together to implement the excellent ideas exchanged here into daily practice."