Can we Improve Care Pathway in Low Back Pain?

Summary

The general objective of this pilot study is to investigate a new multi-level intervention in primary care to improve the care of patients with low back pain. Specifically, it will first investigate the feasibility of delivering this intervention in primary care in Switzerland. Second, it will evaluate the effectiveness of the intervention on the use of unnecessary imaging and unhelpful medication in primary care, the risk of developing chronic disabling care, and direct and indirect healthcare costs.

In this two-arm parallel pilot study, it is the general practitioners that will be recruited to be in either arm. In the intervention group, they will deliver the multi-level intervention that consists of:

* Stratifying care based on the risk of chronicity
* Improving healthcare professional education
* Improving patient education
* Facilitating interprofessional communication

General practitioners in the control group will have no specific training or intervention. They will treat patients according to their usual practice.

Conditions

• Back Pain, Low

Interventions

OTHER

Implementation of best practice for low back pain in primary care

1. Stratified care: GPs will use a simple algorithm based on the risk of chronicity to determine the management plan. The risk level bas will be based on the Start Back Tool (SBT) and other variables that have been shown to improve the classification, such as work capacity. 2. Healthcare professional education: GPs will receive education to improve their knowledge about low back pain guidelines, diagnostic triage, patient education, stratified care and best practice. 3. Patient education: An education booklet "Understanding My Low Back Pain" will be used by GPs during their consultations. Second, GPs, PTs and OTs will provide similar reassuring messages and direct patients to the website www.infomaldedos.ch. 4. Interprofessional collaboration: A structured assessment form and a facilitated contact will be implemented between healthcare providers.

Sponsors & Collaborators

• Haute Ecole de Santé Vaud

  collaborator OTHER

• Delta SA

  collaborator UNKNOWN

• University of Applied Sciences of Western Switzerland

  collaborator OTHER

• smarter medicine choosing wisely Switzerland

  collaborator UNKNOWN

• University Hospital, Geneva

  lead OTHER

Principal Investigators

• Stéphane Genevay, Prof · University Hospital, Geneva

Study Design

Allocation

NON_RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-06-05

Primary Completion

2024-04-30

Completion

2024-04-30

Countries

• Switzerland

Study Locations