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Continuity and quality in the rehabilitation of patients with diseases and ailments in the musculoskeletal system

Project managers
Post doc
PhD fellow


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

The BRIDGE project's objective was to improve continuity and quality in the rehabilitation process for each patient, across levels of the health service and other sectors involved such as NAV, work and education. We developed a rehabilitation program that was intended to act as a bridge between the specialist healthcare service and the primary healthcare service, to achieve a course that was coherent and coordinated. The elements of the program were: Individual rehabilitation goals, written plans with measures to achieve the goals, including the patient's own efforts and follow-up from relevant agencies. Other elements were visual reports for feedback on progression along the way, and the use of motivational interviews to ensure a high degree of patient involvement from goal setting to follow-up over time.



Recruitment has ended.

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


The study has two main purposes:

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

Other purposes are to investigate whether good follow-up after returning home predicts high goal attainment, improved quality of life and function one year after starting the rehabilitation process, as well as to investigate the patients' experience with the BRIDGE programme. BRIDGE was designed as a randomized controlled trial with a staircase design. That is, each center switched from control (current rehabilitation program) to intervention (adding the BRIDGE program) in a predetermined, randomized order. The patients who participated were followed up for one year with electronic data collection at entry, exit and after 2, 7 and 12 months. Within this design, sub-studies have been carried out which consist of both quantitative surveys and qualitative approaches which have included research interviews with patients and healthcare personnel. Data collection was completed in June 2019. We are now working with data analyzes and dissemination.