Using developmental research to design innovative knowledge translation technology for spinal cord injury in primary care: Actionable Nuggets™ on SkillScribe™

Promoting Long-Term Health among People with Spinal Cord Injury: What's New?

A key ingredient to successful health promotion is a primary care provider who can offer an informed first response to lifestyle issues, emerging problems and chronic challenges. This article aims to assist family physicians to play their role in promoting the health of people with SCI, by summarizing the latest evidence in the management of spinal cord injury in primary care. This study used a scoping review methodology to survey peer-reviewed journal articles and clinical guidelines published between January 2012 to June 2016. This search strategy identified 153 articles across 20 topics. A prevention framework is used to identify five primary, nine secondary, four tertiary, and two quaternary prevention issues about which family physicians require current information. Major changes in the management of SCI in primary care were noted for 8 of the 20 topics, specifically in the areas of pharmacological management of neuropathic pain and urinary tract infection; screening for bowel and bladder cancer; improvements in wound care; and clarification of dietary fibre recommendations. All of these changes are represented in the 3rd edition of Actionable Nuggets-an innovative tool to assist family physicians to be aware of the best practices in primary care for spinal cord injury.

Primary care for persons with spinal cord injury - not a novel idea but still under-developed

Primary care for persons with spinal cord injury (SCI) has long been recognized as an important issue. Over the last two decades, there has not been any consensus on its contents, pathway or delivery model. Despite the lack of attention on this issue, various health care organizations and settings have successfully developed their own version of primary care for persons with SCI. On the other hand, persons with SCI have also found different ways to obtain primary care through Family Physicians and specialists, often depending on the health care structure of their country. This has blurred the line between what is traditionally seen as primary vs. specialist care. The "medical home" model may be ideal for SCI primary care, and it may be establishsed in different care settings. In order to create this model, health care funding structure, appropriate access to physical facility and SCI knowledge, interdisciplinary provider availability and collaboration, as well as active engagement with persons with SCI are necessary. The SCI community should endorse SCI primary care with effective advocacy and implementation.