Back to Search
Start Over
Effectiveness of Stratified Treatment for Back Pain in Danish Primary Care:A randomized controlled trial
- Source :
- Morsø, L, Rose, K O, Schiøttz-Christensen, B, Sowden, G, Søndergaard, J & Christiansen, D H 2021, ' Effectiveness of Stratified Treatment for Back Pain in Danish Primary Care : A randomized controlled trial ', European Journal of Pain, vol. 25, no. 9, pp. 2020-2038 . https://doi.org/10.1002/ejp.1818, Morsø, L, Olsen Rose, K, Schiøttz-Christensen, B, Sowden, G, Søndergaard, J & Christiansen, D H 2021, ' Effectiveness of stratified treatment for back pain in Danish primary care : A randomized controlled trial ', European Journal of Pain (United Kingdom), vol. 25, no. 9, pp. 2020-2038 . https://doi.org/10.1002/ejp.1818, European Journal of Pain (London, England)
- Publication Year :
- 2021
-
Abstract
- Background: A randomized controlled trial (RCT) of stratified care demonstrated superior clinical outcomes and cost-effectiveness for low back pain (LBP) patients in UK primary care. This is the first study in Europe, outside of the original UK study, to investigate the clinical efficacy and cost-effectiveness of stratified care compared with current practice for patients with non-specific LBP. Methods: The study was a two-armed RCT. Danish primary care patients with LBP were randomized to stratified care (n = 169) or current practice (n = 164). Primary outcomes at 3- and 12-months' follow-up were Roland Morris Disability Questionnaire (RDMQ), patient-reported global change and time off work. Secondary outcomes included pain intensity, patient satisfaction, healthcare resource utilization and quality-adjusted life years. Results: Intention-to-treat analyses found no between-group difference in RMDQ scores at 3 months (0.5, 95% CI −1.8 to 0.9) or 12 months (0.4, −2.1 to 1.3). No overall differences were found between the arms at 3 and 12 months with respect to time off work or secondary outcomes. Stratified care intervention resulted in significantly fewer treatment sessions (3.5 [SD 3.1] vs. 4.5 [3.5]) and significantly lower total healthcare costs (€) (13.4 [529] vs. 228 [830], p =.002). There was no difference in cost-effectiveness (0.09, 0.05 to 0.13 vs. 0.10, 0.07–0.14, p =.70). Conclusions: There was no significant difference in clinical outcomes between patients with non-specific LBP receiving stratified care and those receiving current practice. However, stratified care may reduce total healthcare costs if implemented in Danish primary care. Significance: Stratified care for low back pain based on risk profile is recommended by recent evidence based clinical guidelines. This study is the first broad replication of the STarT Back Trial in Europe. Therefore, the study adds to the body of knowledge evaluating the effectiveness of stratified care for low back pain in primary care, and provides insight into the effects of stratification on clinical practice.
- Subjects :
- medicine.medical_specialty
Evidence-based practice
Cost effectiveness
Denmark
law.invention
Patient satisfaction
Randomized controlled trial
law
RA0421
Health care
Back pain
Humans
Medicine
Primary Health Care
business.industry
Original Articles
Low back pain
Treatment Outcome
Anesthesiology and Pain Medicine
Roland Morris Disability Questionnaire
Physical therapy
Original Article
Quality-Adjusted Life Years
medicine.symptom
business
Low Back Pain
RA
Subjects
Details
- Language :
- English
- ISSN :
- 10903801
- Database :
- OpenAIRE
- Journal :
- Morsø, L, Rose, K O, Schiøttz-Christensen, B, Sowden, G, Søndergaard, J & Christiansen, D H 2021, ' Effectiveness of Stratified Treatment for Back Pain in Danish Primary Care : A randomized controlled trial ', European Journal of Pain, vol. 25, no. 9, pp. 2020-2038 . https://doi.org/10.1002/ejp.1818, Morsø, L, Olsen Rose, K, Schiøttz-Christensen, B, Sowden, G, Søndergaard, J & Christiansen, D H 2021, ' Effectiveness of stratified treatment for back pain in Danish primary care : A randomized controlled trial ', European Journal of Pain (United Kingdom), vol. 25, no. 9, pp. 2020-2038 . https://doi.org/10.1002/ejp.1818, European Journal of Pain (London, England)
- Accession number :
- edsair.doi.dedup.....7cc03adca3faf9f927942c8ba285fbb4