Back pain management programme low cost and effective – claim
Friday September 30th, 2011
A trial on a new way of managing patients with back pain has resulted in more effective and cheaper treatment, it has been claimed.
Carried out by researchers at the Arthritis Research UK Primary Care Centre, Keele University, Stoke-on-Trent, UK, the STarT Back trial investigated the efficacy of "stratified care", which is a type of care that is tailored to an individual.
The care system involves asking patients to fill out a simple questionnaire with nine questions. Patients are placed into one of three groups, based on the risk of persistent disability.
Treatments are then tailored to each of these groups to improve outcomes.
A total of 851 adults who reported back pain took part in a trial between June 2007 and November 2008. Of those, 568 were randomly assigned to stratified care and the remaining 283 were given existing best practice of advice, exercise and manual therapy delivered by physiotherapists.
When they were followed up at four months and 12 months, patients in the stratified care group showed a significant improvement in disability scores compared with patients in the control group, it was announced yesterday.
Researchers found that those in the stratified group were also more likely to report reduced fear, less depression, and better general health. They were significantly more likely to be satisfied with their treatment compared with current best care at four months, and took fewer days off work because of back pain over the 12-month study period.
The stratified management intervention also resulted in a greater health benefit that was achieved at a lower average health-care cost, an average saving of £34.39 per patient.
Researcher Dr Jonathan Hill said: "The traditional diagnostic approach has not really been working. It has not been systematic enough in helping us identify the patients with all the serious problems and those that get better by themselves.
"At the moment it's left to clinical intuition. Can we be more efficient so we are not missing the people who are going to end up with serious problems and we are not over-treating people who are going to get better anyway?"
Writing Online First in The Lancet, the authors say: “The results of this trial provide the first evidence that a stratified management approach to target the provision of primary care significantly improves patient outcomes and is associated with substantial economic benefits compared with current best practice.
“The findings of this study represent an important advance in primary care management of back pain, and have important implications for commissioners and providers of services for back pain.”
In a Comment, Bart Koes from Erasmus University Medical Centre, Rotterdam, The Netherlands, says: “The economic assessment showed the new approach was cost-effective so there is no financial reason not to implement the new intervention.”
Tags: NHS | Pain Relief | UK News
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