A Stratified Approach for Managing Patients With Low Back Pain in Primary Care (SPLIT Program): A Before-and-After...

Area of Science:

• Primary care research
• Musculoskeletal health
• Evidence-based practice

Background:

• Low back pain (LBP) is a prevalent condition in primary care settings.
• Current usual care (UC) for LBP may not consistently optimize patient outcomes.
• Stratified care models aim to match patients with appropriate interventions based on their needs.

Purpose of the Study:

• To evaluate the effectiveness of the Stratified Primary care for low back pain (SPLIT) program.
• To assess the impact of SPLIT on reducing back-related disability in primary care patients.
• To compare health-related outcomes between the SPLIT program and usual care.

Main Methods:

• A before-and-after study design comparing two independent cohorts of LBP patients.
• Implementation of the SPLIT program utilizing the STarT Back Screening Tool for patient stratification.
• Comparison of back-related disability, pain, perceived treatment effect, and quality of life between UC and SPLIT cohorts.

Main Results:

• Patients in the SPLIT program demonstrated significantly greater improvements in back-related disability (ß = -2.94, P ≤ .001).
• The SPLIT program led to significant reductions in pain (ß = -0.88, P ≤ .001) and enhanced perceived treatment effect (ß = 1.40, P ≤ .001).
• Health-related quality of life also showed significant improvement in the SPLIT cohort (ß = 0.11, P ≤ .001) compared to UC.

Conclusions:

• The SPLIT program offers superior health-related outcomes for patients with low back pain in primary care.
• Stratified care, as implemented in the SPLIT program, is an effective approach for managing LBP.
• These findings support the adoption of stratified care models in primary care for LBP management.