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A classification-based approach to low back pain in primary care - protocol for a benchmarking controlled trial.
- Source :
-
BMC family practice [BMC Fam Pract] 2020 Apr 06; Vol. 21 (1), pp. 61. Date of Electronic Publication: 2020 Apr 06. - Publication Year :
- 2020
-
Abstract
- Background: Guidelines recommend a biopsychosocial framework for low back pain (LBP) management and the avoidance of inappropriate imaging. In clinical practice, care strategies are often inconsistent with evidence and guidelines, even though LBP is the most common disabling health condition worldwide. Unhelpful beliefs, attitudes and inappropriate imaging are common. LBP is understood to be a complex biopsychosocial phenomenon with many known multidimensional risk factors (symptom- and lifestyle-related, psychological and social) for persistent or prolonged disability, which should be identified and addressed by treatment. The STarT Back Tool (SBT) was developed for early identification of individual risk factors of LBP to enable targeted care. Stratified care according SBT has been shown to improve the effectiveness of care in a primary care setting. A biopsychosocially-oriented patient education booklet, which includes imaging guidelines and information, is one possible way to increase patients' understanding of LBP and to reduce inappropriate imaging. Premeditated pathways, education of professionals, written material, and electronic patient registry support in health care organizations could help implement evidence-based care.<br />Methods: We will use a Benchmarking Controlled Trial (BCT) design in our study. We will prospectively collect data from three health care regions before and after the implementation of a classification-based approach to LBP in primary care. The primary outcome will be change in PROMIS (Patient-Reported Outcomes Measurement Information System) (short form 20a) over 12-month follow-up.<br />Discussion: The implementation of a classification-based biopsychosocial approach can potentially improve the care of LBP patients, reduce inappropriate imaging without increasing health-care costs, and decrease indirect costs by reducing work disability. Using the BCT we will be able to evaluate the effectiveness of the improvement strategy for the entire care pathway.<br />Trial Registration: ISRCTN,ISRCTN13273552, retrospectively registered 13/05/2019.
- Subjects :
- Adult
Female
Humans
Implementation Science
Male
Models, Biopsychosocial
Patient Reported Outcome Measures
Patient-Centered Care
Benchmarking methods
Low Back Pain classification
Low Back Pain physiopathology
Low Back Pain psychology
Low Back Pain therapy
Pain Measurement classification
Pain Measurement methods
Patient Care Management methods
Patient Care Management organization & administration
Patient Care Management standards
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2296
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC family practice
- Publication Type :
- Academic Journal
- Accession number :
- 32252643
- Full Text :
- https://doi.org/10.1186/s12875-020-01135-8