Continuity and quality in the rehabilitation of patients with musculoskeletal diseases and disorders

project manager

About the project

People with rheumatic disease may need rehabilitation one or more times during the course of the disease. Many of them receive such rehabilitation services in the specialist health service, with expected follow-up after discharge from services relevant to the individual patient. In public evaluations of rehabilitation services, suboptimal quality of such pathways has been pointed out, with too little patient involvement and services that are poorly coordinated and poorly coordinated.

The aim of the BRIDGE project was to improve the continuity and quality of the rehabilitation pathway for each patient, across levels of health care and other involved sectors such as social services, employment and education. We developed a rehabilitation program that was intended to act as a bridge between specialist and primary care to achieve a coherent and coordinated pathway. The elements of the program were: Individual rehabilitation goals, written plans with actions to achieve the goals, including the patient's own efforts and follow-up from relevant agencies. Other elements were visual reports for feedback on progress along the way, and the use of motivational interviewing to ensure a high degree of patient involvement from goal setting to follow-up over time.

Who can participate?

Recruitment is closed.

Included patients were adults in need of multidisciplinary rehabilitation in specialist health care due to the following diseases: Inflammatory rheumatic disease, connective tissue disease, osteoarthritis, unspecified neck, shoulder or low back pain, and fibromyalgia or widespread pain syndrome.

Project arrangement

The study has two main purposes:

  • to evaluate the effect of the BRIDGE program on patient-reported outcome, function and health-related quality of life, compared to traditional rehabilitation programs at eight rehabilitation sites in Norway.
  • to measure, monitor and improve the quality of the rehabilitation process. This includes the use of quality indicators, reported by both patients and healthcare professionals.

Other aims are to investigate whether good follow-up after discharge predicts high goal attainment, improved quality of life and function one year after the start of the rehabilitation process, and to investigate the patients' experience with the BRIDGE program. BRIDGE was designed as a randomized controlled trial with a staged design. That is, each center switched from control (current rehabilitation program) to intervention (adding the BRIDGE program) in a predetermined, randomized order. Participating patients were followed up for one year with electronic data collection at entry, discharge and at 2, 7 and 12 months. Within this design, sub-studies have been conducted consisting of both quantitative surveys and qualitative approaches that have included research interviews with patients and healthcare professionals. Data collection was completed in June 2019. We are now working on data analysis and dissemination.


All rights reserved © REMEDY; Illustration/portrait images © Nicolas Tourrenc/Diakonhjemmet Hospital