A classification-based approach to low back pain in primary care - protocol for a benchmarking controlled trial
A S Simula1,2, A Malmivaara3, N Booth4
1Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. anna.simula@oulu.fi.
BMC Family Practice
|April 8, 2020
Summary
This study evaluates a classification-based biopsychosocial approach for low back pain (LBP). Stratified care using the STarT Back Tool (SBT) aims to improve patient outcomes and reduce unnecessary imaging.
Area of Science:
- Health Services Research
- Musculoskeletal Disorders
- Evidence-Based Practice
Background:
- Low back pain (LBP) is a leading cause of disability globally, often managed inconsistently with guidelines.
- Current practice frequently involves unhelpful patient beliefs and inappropriate imaging, despite LBP being a complex biopsychosocial issue.
- The STarT Back Tool (SBT) aids in identifying LBP risk factors for targeted, stratified care, improving primary care effectiveness.
Purpose of the Study:
- To evaluate the effectiveness of implementing a classification-based biopsychosocial approach for low back pain (LBP) management.
- To assess the impact of this approach on patient-reported outcomes and the utilization of inappropriate imaging.
- To determine the potential for reducing healthcare costs and work disability associated with LBP.
Main Methods:
- A Benchmarking Controlled Trial (BCT) design will be employed.
- Data will be prospectively collected from three healthcare regions before and after implementing a classification-based LBP approach.
- The primary outcome measure is the change in Patient-Reported Outcomes Measurement Information System (PROMIS) scores over 12 months.
Main Results:
- The implementation of a classification-based biopsychosocial approach is anticipated to enhance LBP patient care.
- A reduction in inappropriate imaging is expected without an increase in healthcare costs.
- The study aims to decrease indirect costs by mitigating work disability.
Conclusions:
- A classification-based biopsychosocial approach offers a promising strategy for improving LBP management.
- This approach has the potential to optimize patient outcomes, reduce unnecessary diagnostic procedures, and lower overall healthcare burden.
- The BCT design will provide a comprehensive evaluation of the implemented care pathway's effectiveness.
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