1. Nurse-protocol management of low back pain. Outcomes, patient satisfaction and efficiency of primary care.
- Author
-
Greenfield S, Anderson H, Winickoff RN, Morgan A, and Komaroff AL
- Subjects
- Adolescent, Adult, Aged, Back Pain diagnosis, Child, Consumer Behavior, Female, Humans, Male, Middle Aged, Nursing Assessment, Patient Acceptance of Health Care, Primary Health Care, Quality of Health Care, Referral and Consultation, Back Pain therapy, Nurses statistics & numerical data
- Abstract
To test the validity of a nurse-administered protocol for low back pain, a prospective trial of 419 patients was undertaken in a walk-in clinic. In all, 222 patients were randomly allocated to a "nurse-protocol group" in which they were evaluated by one of five nurses using the protocol; the nurses independently managed 53 percent of the patients and referred to a physician patients with potentially complex conditions. In addition, 197 patients in a randomly allocated control group were managed by one of 32 physicians. Care in the experimental and control groups was compared by follow-up telephone contact and by a four-month chart review. There was no significant difference in symptomatic relief or the development of serious disease in the two groups. Nurse-protocol patients expressed greater satisfaction with the care they had received; patient satisfaction correlated positively with symptom relief. In over 95 percent of the patients, there were noncomplex, nonserious, nonchronic conditions as the cause of back pain. We conclude that nurse-protocol management of this generally benign condition in a primary care setting is both effective and efficient.
- Published
- 1975