Ab1199 barriers and Facilitators to the Implementation of a Stratified Model of Care for Low Back Pain Patients in Primary Care in Portugal

et al. 2020

Preprint

Background: Chronic low back pain is associated with disability and work absence. Stratified primary care management of acute low back pain using a prognostic screening tool (STarT Back) allows triage of those at risk of chronicity. Primary health practitioners can use this method of stratification to assess patients with low back pain then allocate them to matched treatment groups. STarT Back was designed for use in the health service in the United Kingdom (UK) where stratification using STarT Back has been shown to improve clinical outcomes, patient satisfaction, and reduce treatment costs and time off work. Implementation of STarT Back in health care systems outside of the UK is in an early stage and its success is dependent on the health practitioners using it and the healthcare system in which they work. Gaining health practitioners’ perspectives on STarT Back is an important step in effective implementation. This will help contextualise the tool to each healthcare environment, making it easier and more meaningful for intended users. Methods: A computerised search of qualitative literature was conducted across seven databases in August 2020 using keywords to identify studies that investigate the perspectives of physiotherapists and general practitionners on the use of STarT Back in primary health care. Study quality was assessed using the CASP tool. Data were analysed using reflexive thematic analysis. Results: Eight articles met the inclusion criteria where qualitative data was retrievable and included the views of general practitioners and physiotherapists from primary health care settings from four countries. Participants’ perspectives varied across the data, and three key themes were created from these findings: ‘making it work’, ‘will I do it?’, and ‘it’s all about the patient’. Conclusions: Physiotherapists and general practitioners found using STarT Back frequently enhanced their practice. General practitioners did express concerns about time constraints and the potential for STarT Back to undermine their clinical experience. Findings from this study will inform adaptations of STarT Back to ensure successful implementation into different health contexts.

Section: Literature Searchmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Making It Workmentioning

confidence: 99%

Section: Will I Do It?mentioning

confidence: 99%

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confidence: 99%

See 3 more Smart Citations

The perspectives and experiences of physiotherapists and general practitioners in the use of the STarT Back Tool: A review and meta-synthesis.

et al. 2020

Preprint

Perspectives and experiences of physiotherapists and general practitioners in the use of the STarT Back Tool: a review and meta-synthesis

et al. 2022

J. Prim. Health Care

Introduction. The STarT Back Tool (SBT) is used to triage people with acute low back pain (LBP) into treatment groups, matched to their risk of chronicity. It was developed in the UK where it has been shown to improve clinical outcomes, patient satisfaction, and reduce time off work. Successful implementation of the SBT outside the UK is dependent on health practitioner's attitudes and the healthcare system in which they work. Gaining health practitioners' perspectives on the SBT is an important step in implementation. Methods. A computerised search of qualitative literature was conducted across seven databases in March 2021 using keywords to identify studies investigating the perspectives of physiotherapists and general practitioners on the use of the SBT in primary health care. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tool. Data were coded and analysed using reflexive thematic analysis. Results. Eight articles met inclusion criteria and included the views of 76 physiotherapists and 65 general practitioners, working in primary health care in four countries. Three themes were created from the data: 'Making it work', identifies factors that influence implementation and continued use of the SBT. The second 'will I do it?', captured potential consequences of adopting the SBT, and the third, 'it's all about the patient' emphasised how the SBT may affect patients. Discussion. Physiotherapists and general practitioners found using the SBT frequently enhanced practice. General practitioners expressed concerns about time constraints and the SBT's potential to undermine clinical experience. Findings from this study will inform modifications to contextualise the tool to each healthcare environment.

The perspectives and experiences of physiotherapists and general practitioners in the use of the STarT Back Tool Tool: A review and meta-synthesis.

et al. 2021

Preprint

Background: Chronic low back pain is associated with disability and work absence. Stratified primary care management of acute low back pain using a prognostic screening tool (STarT Back Tool, SBT) triages people with LBP into targeted treatment groups, matched to their level of risk of chronicity. The SBT was designed for use in the health service in the United Kingdom where it has been shown to improve clinical outcomes, patient satisfaction, and reduce treatment costs and time off work. Successful implementation of the SBT outside the UK is dependent on the health practitioners who will use it and the healthcare system in which they work. Gaining health practitioners’ perspectives on the SBT is an important step in implementation. Methods: A computerised search of qualitative literature was conducted across seven databases in March 2021 using keywords to identify studies investigating the perspectives of physiotherapists and general practitionners on the use of the SBT in primary health care. Study quality was assessed using the CASP tool. Data were coded and analysed using reflexive thematic analysis. Results: Eight articles met inclusion criteria and included the views of general practitionners and physiotherapists from primary health care settings from four countries. Three themes were created from the data, the first ‘making it work’, identifies factors that may influence implementation and continued use of the SBT in clinical practice. The second ‘will I do it?’, captured potential consequences of adopting the SBT and the third, ‘it’s all about the patient’ emphasised how the SBT may affect patients and their potential reactions. Conclusions: Physiotherapists and general practitionners found using the SBT frequently enhanced their practice. General practitioners expressed concerns about time constraints and potential for the SBT to undermine their clinical experience. Findings from this study will inform modifications to contextualise the tool to each healthcare environment.