2023 WRAP
Wishing you all the best for the coming year
A WORD FROM THE DIRECTOR It’s been a very busy year for the CRE! I’m very grateful for the hard work of my team here at The University of Queensland, my Chief Investigator partners and their teams at The University of Sydney, Monash University and The University of Melbourne. I thank the members of our Policy and Clinical Advisory Groups, our research funders, the members of the newly formed Consumer Advisory Groups, and you, our supporters. On a personal note, I was very surprised and honoured to receive Research Australia’s 2023 Health Services Research Award! Thank you Research Australia, the NSW government who sponsored the award and MAIC for supporting my nomination. In recent news, I’m excited to be a Chief Investigator on a new NHMRC Synergy Grant (2024-2028) led by Professor Paul Hodges at UQ. The grant “DISCERN Disciplinary Integration to Solve the Enigma of Chronic Pain: Evaluating personalised care and its impact with innovative clinical trials and research in neurobiology, psychology and society” is highly relevant to the activities of the CRE. A summary of our activities over the last 12 months follows.
MICHELE STERLING
OUR AIMS
IMPROVE INJURY MANAGEMENT WITHIN AND ACROSS SYSTEMS Non-catastrophic road traffic injury (RTI) typically affects the neck and spine (whiplash) and the upper and lower limbs. Although classified as being ‘minor’ injuries, health outcomes are often poor.
Through gaining an understanding of the complex interactions between the health, compensation and legal systems, the CRE aims to improve injury management within and across those systems. However, our main priority is health outcomes. We have shown that, in Australia, less than 50% of people with non-catastrophic RTI develop chronic pain, disability and psychological co-morbidities including posttraumatic stress, depression and anxiety. Following consultation with key stakeholders, three key priority areas were identified which set the CRE’s research, implementation and training agenda:
DATA TO DRIVE SYSTEM CHANGE IMPLEMENTING BEST-PRACTICE MODELS OF CARE REDUCING THE IMPACT OF SYSTEM FACTORS ON INJURED PEOPLE
OUR PROGRESS 1: DATA TO DRIVE SYSTEM CHANGE
PROF IAN CAMERON
PROF ALEX COLLIE
Dr Annette Kifley and I have focused on long-term consequences of injury for physical health, mental health, work and social outcomes under the former and current CTP compensation schemes in NSW.
The Monash team have made excellent progress in linking data from various compensation and benefit schemes, which has produced new novel datasets.
Studying outcomes for two years after injury, both before and after scheme reforms, has provided a comparison of scheme outcomes, and insights into pathways and experiences of people who claim and people who do not claim. Findings will be published in 2024.
Our Transition study revealed that 2 in 3 transport injuries which led to long workers compensation claims were “minor” injuries! Stay tuned for two papers awaiting publication from this study. Working with the USYD team, two new studies specific to CTP claims are now underway.
ASSOCIATE PROF JASON THOMPSON
DR NIGEL ARMFIELD
Dr Fjalar de Haan and I were very excited to launch our GENSIMO: GENeric Social Insurance MOdelling platform, through which we have developed the first backbone of a claims-based system.
While more serious road traffic injuries are well understood, little is known about the burden of non-catastrophic road traffic injuries, despite these being the most common and most costly to insurance schemes, with recovery often being poor. It is an unacceptable paradox that the group of people accounting for most injuries are the ones we know the least about.
This model plots client trajectories within a scheme, building capability to engage with issues such as segmentation and customised care, patient centric experiences, the roles of various actors and demographic change. Ultimately, this will enable us to explore and predict immediate and longer-term effects on criteria such as recovery trajectories and health outcomes of injured people, satisfaction and trust in the system, and costs over time.
My vision is for Better Data for Better Outcomes, with a particular focus on filling the knowledge gaps relating to the epidemiology and burden of minor-to-moderate road traffic injury. With CRE colleagues, I am leading work to pool the best available international data to characterise the recovery of quality of life after injury, including recovery trajectories, and to estimate novel disability weights. A PhD student will join the UQ team in 2024 to advance this important work.
2: IMPLEMENTING BEST-PRACTICE MODELS OF CARE
PROF MICHELE STERLING
The UQ team have commenced activities related to our two MRFF clinical trials. Six hospital emergency departments throughout Australia and 30 physiotherapy clinics have been recruited. We’ve developed the protocols for both trials and participant recruitment will commence in early 2024. We were also very pleased to welcome on board members of the Consumer Advisory Groups, with whom we’ll work to progress both trials. We’ve also been busy finalising interactive online training modules for physiotherapists to improve their provision of biopsychosocial care for people with acute whiplash injury. The six modules provide physiotherapists with education in the delivery of stress inoculation training integrated with physiotherapy. Whilst physiotherapists recognise the need to address psychological distress in patients with road traffic injury, they lack the confidence and skills to do so. The training modules will address this issue. They are now publicly available on the my whiplash navigator website. Thank you to Dr Rachel Elphinston, Dr Yanfei Xie and Chloe-Emily Eather for their hard work in getting the modules to this point.
ASSOCIATE PROF GENEVIEVE GRANT
I’ve hit the ground running here at Monash, leading the CRE’s research into legal policy and practices relating to CTP compensation claims. Two new exciting projects investigating advocacy and collaboration in personal injury law will be undertaken by new PhD scholars in 2024. We’re excited to commence this work which will inform the development and implementation of Best Practice Principles for Legal Practitioners.
PROF TRUDY REBBECK
Focusing on the implementation of improved models of care, the USYD team has produced new educational modules for the my whiplash navigator online resource. Whiplash case studies will take clinicians through interactive case studies for people with low, medium and high risk outcomes, providing real-time feedback. The modules are now live in my whiplash navigator. Simply log in to access. Produced in collaboration with other stakeholders, the revised Australian Clinical Guidelines for Whiplash Associated Disorder will be publicly available in the coming months.
3: REDUCING THE IMPACT OF SYSTEM FACTORS ON INJURED PEOPLE Consumer-focused (patient-centred) strategies are an essential component of injury management to improve health outcomes. Under this Priority Area 3, the UQ team are developing and testing the following patient-centred resources: A co-designed supportive SMS text message intervention for people with acute whiplash-associated disorders. My Injury Pilot an mHealth intervention to improve patient and clinician communication as well as increase accessibility to the successful StressModex intervention. OMED Assist a digital brief intervention to increase safe use of opioids for people with chronic pain. These projects are being led by Dr Rachel Elphinston and Dr Karime Mescouto.
DR RACHEL ELPHINSTON
DR KARIME MESCOUTO
“I’ve explored potential opportunities to enhance the value of psychological interventions delivered through digital platforms for people living with pain. In 2024, I’m aiming to recruit patients and healthcare professionals to share their experiences in using digital psychological interventions and identify possible solutions to improve use and engagement of these interventions in everyday clinical practice.”
SPOTLIGHT ON POSTGRAD PROJECTS
Chloe-Emily Eather, UQ
Enhancing engagement in digital psychological therapies for patients with chronic non-cancer pain
“I've started a systematic review and meta-analysis looking at clinical differences between people with chronic whiplash and chronic non-traumatic neck pain. Preliminary findings indicate that people with chronic whiplash tend to experience more significant disability and heightened sensitisation compared to those with chronic non-traumatic neck pain. Stay tuned for more details! I'm aiming to submit this paper before March next year!"
Junze Chen, UQ Classification of Whiplash Associated Disorders Using Contemporary Evidence
“I've finished the search strategy for my systematic review and have imported all the references into Covidence. I'm now in the process of title and abstract screening, and recently met with my second reviewer in Melbourne for full text screening.”
Simone Yu, Monash Mental health service use following minor to moderate motor vehicle crash: A systematic review
“My research examines the subjective experience of individuals injured in motor vehicle crashes in NSW. My goals are to understand the service- and system-related factors influencing their experience, translate these insights into service- and system-level improvements, ultimately facilitating improved outcomes for individuals.”
Joseph Lennon, USYD Better health outcomes for compensable injury’
COLLABORATION Through presentations at numerous conferences and delivery of workshops and seminars, we have successfully strengthened our national and international collaborations. Other direct collaborations have included:
REGULATOR SUPPORT We extend our heartfelt thanks to the continued support of MAIC, SIRA, TAC and SA CTP in accessing data for our research projects, consultations to inform the systems modelling, and participation in our Advisory Group meetings.
NEW PROJECT PARTNERS Through funding provided by MAIC and SIRA, and the support of our partners Australian Physiotherapy Association and Painaustralia, we have created informative resources for my whiplash navigator, and commenced the two new ground breaking MRFF clinical trials.
ADVISORY GROUPS Two roundtable meetings were held with our Policy and Clinical Advisory Groups. The first focused on regulator research priorities; the second on the clinical research being undertaken by the CRE. Both meetings were fruitful and provided important feedback and opinion to inform the direction of our work.
ConsoRTI The International Consortium (ConsoRTI), formed during the NHMRC CRE in Recovery following Road Traffic Injuries (2014-2019), produced the first recommendations on core outcome measurement instruments for whiplash associated disorder. Eight new members have joined the ConsoRTI for this CRE, which aims to create a series of publications on whiplash associated disorder. Activities will also include revision of the current Quebec Task Force Classification system.
INAUGURAL SYMPOSIUM Held in Brisbane, this hybrid event, co-hosted with UQ’s RECOVER Injury Research Centre, was attended by over 180 delegates from insurance, allied health, academia and the community. The 2024 Symposium will be held at The University of Sydney on 12 June.
READ OUR LATEST PUBLICATIONS
BLANK PAGE
cre-rfrti.centre.uq.edu.au
whiplashresearch@uq.edu.au
cre-rfrti.centre.uq.edu.au
© The University of Queensland ABN: 63 942 912 684 CRICOS: 00025B TEQSA: PRV12080