Amélioration de l'accès et de la qualité des soins de santé chez les patients présentant des troubles musculosquelettiques communs


François Desmeules

Université de Montréal


Domaine : appareil locomoeur et arthrite

Programme chercheurs-boursiers - Junior 1

Concours 2015-2016

Musculoskeletal disorders are common in the general population and access to quality care is problematic. The first project of my research program is aimed at the identification of patients at risk of poor outcomes after knee replacement surgery. An important proportion of patients will report persistent disabilities after this surgery. However, factors associated with poor outcomes are not well understood for knee replacement. This study aims at developing a decision aid (prediction rule) to help clinicians identify, before surgery, patients at risk of poor outcome. Data from a cohort of patients undergoing knee replacement and followed in time will be used to develop the rule. The second project aims at improving the diagnostic validity of physical examination tests for common knee disorders. Many clinicians are not able to provide a valid diagnosis following a clinical physical exam of the knee.

This study will develop a decision aid (prediction rule) to help clinicians make valid diagnoses of knee disorders. A diagnostic study will be undertaken where a series of patients with knee pain will be evaluated by a set of clinicians to establish the relevant elements of the patient history and the findings of clinical physical tests that will allow a valid diagnosis of different knee pathologies. The third project aims at improving access and quality of primary care for patients with osteoarthritis with advanced practice physiotherapists. Access and the quality of primary care for patients with osteoarthritis is a problem. Advanced practice physiotherapists, similar to nurse practitioners, are physiotherapists in more autonomous roles and with medical delegated acts that can diagnose and treat patients with OA.

This study will follow a series of patients with OA and will compare the efficacy of care provided by advanced practice physiotherapists compared to usual care by family physicians in a family health group.