1. Musculoskeletal Health in Europe
Introduction

2. The problem
Musculoskeletal conditions are the single biggest cause of physical disability in the EU; a major cause of healthcare and social support costs; and a major cause of lost productivity
Their prevalence and impact is increasing across Europe
Effective treatments and strategies for their use exist but are not being implemented effectively or with equity across Europe
Reasons include
lack of awareness and knowledge of the impact (epidemiology, costs etc.)
lack of routinely collected indicators that are specifically relevant to musculoskeletal conditions
Musculoskeletal conditions are the biggest cause of physical disability; incur major social care costs and are a major cause of lost productivity. They have significantly contribute to the rates of sickness absence in all Member States (Indicators for Monitoring Musculoskeletal Problems and Conditions Report 2003). Musculoskeletal conditions are the most common medical causes of long-term absence with major consequences for society especially in terms of costs.
Their prevalence and associated disability increases with aging, obesity and lack of physical activity. All these determinants are increasing across Member States.
Recommendations for the prevention and treatment of musculoskeletal conditions have been developed (European Action Towards Better Musculoskeletal Health Report 2004) but these are not being implemented equitably. The management of musculoskeletal conditions differs across Europe and there is evidence that these differences lead affect outcomes. For example, surveys across different European countries have shown different approaches by both people with musculoskeletal conditions and by physicians to the management of musculoskeletal pain. There are also differences in rates of joint replacement surgery across different European countries.
The burden of MSC in all the Member States is large and growing. There is evidence of differences in care between Member States and a failure to implement evidence-based interventions that have potential to reduce the burden.
Reasons for this include lack of awareness and knowledge of the impact (epidemiology, costs etc.) and a lack of routinely collected indicators that are specifically relevant to musculoskeletal conditions.

3. eumusc.net
The eumusc.net project intends to raise and harmonise quality of care and enable equity (environmental, social, gender and geographical) of care of rheumatic diseases and other musculoskeletal conditions across the Member States by developing and operationalising a health surveillance and information system. This will lead to improved musculoskeletal health for all.
An objective of eumusc.net is to provide updated and harmonised information on health, social, employment and economic impact of musculoskeletal conditions across all Member States.
“Musculoskeletal Health in Europe” considers the impact on individuals, populations and on society
The eumusc.net project intends to raise and harmonise quality of care and enable equity (environmental, social, gender and geographical) of care of rheumatic diseases and other musculoskeletal conditions across Europe by further developing and operationalising a health surveillance and information system which is relevant to musculoskeletal health and conditions. This will lead to improved musculoskeletal health for all.
To achieve this, a sustainable health surveillance and information system and network will be developed and operationalised by the 23 partners and embedded within EULAR (the European rheumatology professional, scientific and patient organisation). It will optimise care of musculoskeletal conditions across Member States by setting and monitoring standards, disseminating information and identifying and helping overcome barriers that prevent effective prevention and management of musculoskeletal conditions.
This will be achieved by 1) identifying the burden on individuals and society of musculoskeletal conditions across EU Member States; 2) setting standards of care for individuals and healthcare providers for osteoarthritis and rheumatoid arthritis; 3) assessing whether these are being achieved; and 4) helping overcome the barriers to achieving these standards to enable the effective and equitable prevention and management of these conditions across Europe.

4. Gaining priority and resources through data and evidence.
IMPACT OF MUSCULOSKELETAL DISEASES
WHAT CAN BE ACHIEVED BY “STATE OF THE ART” INTERVENTIONS
UNAVOIDABLE BURDEN
WHAT IS BEING ACHIEVED IN CLINICAL PRACTICE
AVOIDABLE BURDEN OF DISEASE
AD Woolf J Rheumatol 2003; 30 (Suppl 67): 6-9
Understanding the impact of these common, disabling but usually non-fatal conditions will provide the evidence to support the development of strategies and policies for their effective prevention and management. The routine collection of data using agreed indicators of musculoskeletal health that have been made by eumusc.net will enable the assessment of the effectiveness of such strategies on the health of the population – what is being achieved in clinical practice. This will highlight the avoidable burden. The implementation of patient-centred standards of care for the major musculoskeletal conditions and of health care quality indicators to monitor the provision of healthcare will work towards closing the gap between what is and what could be achieved. The development of these standards of care and of healthcare quality indicators are other parts of the eumusc.net project.

5. Indicators INCIDENCE & PREVALENCE HEALTH CARE UTILISATION
DISABILITY AND SOCIAL CONSEQUENCE
HEALTH RELATED QUALITY OF LIFE
POPULATION HEALTH
Eumusc.net project has developed a set of Core Indicators to enable the measurement of the impact of musculoskeletal conditions across States. It is recommended that these should be collected routinely in all Member States. These indicators form the basis of a EU-wide surveillance system which will describe how the impacts of musculoskeletal conditions change over time. The report presents the data from these indicators. It considers the epidemiology of the major musculoskeletal conditions, their impact on individuals, the population and society. This includes health and social care utilisation as well as work loss. This data is given where available for all Member States but at present there is a wide variation across the EU in routine data collection and availability. Where there is a lack of routinely collected data, data from registers and research studies is provided.

6. eumusc.net is an information and surveillance network promoting a comprehensive European strategy to optimise musculoskeletal health. It addresses the prevention and management of MSC’s which is neither equitable nor a priority within most EU member states. It is focused on raising the awareness of musculoskeletal health and harmonising the care of rheumatic and musculoskeletal conditions.
It is a 3 year project that began in February It is supported by the European Community (EC Community Action in the Field of Health ), the project is a network of institutions, researchers and individuals in 22 organisations across 17 countries, working with and through EULAR.
eumusc.net: creating a web-based information resource to drive musculoskeletal health in Europe
Disclaimer The Executive Agency for Health and Consumers is not responsible for any use that is made of the information contained within this publication