Computer-Based Stratified Primary Care for Musculoskeletal Consultations Compared With Usual Care: Study Protocol for...

Area of Science:

• Primary care research
• Musculoskeletal pain management
• Health services research

Background:

• Musculoskeletal (MSK) pain is a leading cause of disability.
• The Start Back Tool effectively guides low back pain management.
• This study expands prognostic stratification to common MSK pain conditions.

Purpose of the Study:

• To evaluate the clinical and cost-effectiveness of stratified care for common MSK pain presentations (back, neck, knee, shoulder, multisite).
• To compare stratified care using the Keele Start MSK Tool against usual nonstratified primary care.

Main Methods:

• Pragmatic, cluster randomized controlled trial in UK primary care (24 general practices).
• Intervention: Keele Start MSK Tool for risk stratification and matched treatment allocation.
• Primary outcome: pain intensity over 6 months; secondary outcomes: physical function, quality of life, cost-effectiveness.

Main Results:

• Recruitment completed (1200 patients, 24 practices) between May 2018 and July 2019.
• Follow-up and data collection concluded in February 2020.
• Results are anticipated by summer 2020.

Conclusions:

• This trial is the first to test prognostic stratified care for primary care MSK pain patients.
• The study aims to provide evidence on the effectiveness and cost-effectiveness of this approach.