European Comparison of Costs and Quality in the Treatment of Acute Back Pain

Gandjour, Afschin; Telzerow, Axel; Lauterbach, Karl W.

doi:10.1097/01.brs.0000158944.54033.60

Cited by 26 publications

(17 citation statements)

References 25 publications

(17 reference statements)

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“…Critically, the management of patients with nsLBP is unsatisfactory and the resultant burden of disease at both individual and societal levels has become significant [2], [3], [4]. Models of care, service delivery and individual practitioner practices in the assessment and management of nsLBP also vary [5], [6] further impacting negatively upon patient outcomes [7]. Barriers to the implementation of current evidence-informed best practice in primary care have been identified [8], [9], [10] and, in parallel, patients continue to seek a pathway towards less pain and disability [11].…”

Section: Introductionmentioning

confidence: 99%

A Policy-into-Practice Intervention to Increase the Uptake of Evidence-Based Management of Low Back Pain in Primary Care: A Prospective Cohort Study

et al. 2012

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BackgroundPersistent non-specific low back pain (nsLBP) is poorly understood by the general community, by educators, researchers and health professionals, making effective care problematic. This study evaluated the effectiveness of a policy-into-practice intervention developed for primary care physicians (PCPs).MethodsTo encourage PCPs to adopt practical evidence-based approaches and facilitate time-efficient, integrated management of patients with nsLBP, we developed an interdisciplinary evidence-based, practical pain education program (gPEP) based on a contemporary biopsychosocial framework. One hundred and twenty six PCPs from primary care settings in Western Australia were recruited. PCPs participated in a 6.5-hour gPEP. Self-report measures recorded at baseline and at 2 months post-intervention included PCPs' attitudes, beliefs (modified Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS), evidence-based clinical practices (knowledge and skills regarding nsLBP management: 5-point Likert scale with 1 = nil and 5 = excellent) and practice behaviours (recommendations based on a patient vignette; 5-point Likert scale).ResultsNinety one PCPs participated (attendance rate of 72%; post-intervention response rate 88%). PCP-responders adopted more positive, guideline-consistent beliefs, evidenced by clinically significant HC-PAIRS score differences (mean change = −5.6±8.2, p<0.0001; 95% confidence interval: −7.6 to −3.6) and significant positive shifts on all measures of clinical knowledge and skills (p<0.0001 for all questions). Self management strategies were recommended more frequently post-intervention. The majority of responders who were guideline-inconsistent for work and bed rest recommendations (82% and 62% respectively) at pre-intervention, gave guideline-consistent responses at post-intervention.ConclusionAn interprofessional pain education program set within a framework that aligns health policy and practice, encourages PCPs to adopt more self-reported evidence-based attitudes, beliefs and clinical behaviours in their management of patients with nsLBP. However, further research is required to determine cost effectiveness of this approach when compared with other modes of educational delivery and to examine PCP behaviours in actual clinical practice.

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Section: Introductionmentioning

confidence: 99%

A Policy-into-Practice Intervention to Increase the Uptake of Evidence-Based Management of Low Back Pain in Primary Care: A Prospective Cohort Study

et al. 2012

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“…4 In 1998, about 17.4 billion Euros per year of the total costs went to treat LBP. 8,9 But even though the majority of patients are seen in primary care settings, 10 the distribution and factors associated with high primary health care costs are hardly known. 7 Health care for patients with LBP is characterized by the variability of providers offering a spectrum of therapies, which are mostly not evidence based.…”

mentioning

confidence: 99%

Low Back Pain in Primary Care

Becker¹,

Held²,

Redaélli³

et al. 2010

Spine

244

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“…Only half that frequency of radiographic studies are ordered in Sweden and Denmark, and a frequency of 0.96 radiographs per resident per year are ordered in the United States (2003 data). In Germany, 33% patients who are treated for acute back pain have radiographs at the first visit [7], much more frequently than 6% patients in the Netherlands, Switzerland, or Great Britain [7,8]. The frequency in our study (Fig.…”

Section: Discussionmentioning

confidence: 48%

Spine radiography in the evaluation of back and neck pain in an orthopaedic emergency clinic

Leichtle

Wünschel

Socci

et al. 2015

BMR

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European Comparison of Costs and Quality in the Treatment of Acute Back Pain

Abstract: There was considerable waste in treating acute back pain. The Netherlands had highest quality and lowest resource utilization in providing treatment for acute back pain.

Cited by 26 publications

References 25 publications

A Policy-into-Practice Intervention to Increase the Uptake of Evidence-Based Management of Low Back Pain in Primary Care: A Prospective Cohort Study

A Policy-into-Practice Intervention to Increase the Uptake of Evidence-Based Management of Low Back Pain in Primary Care: A Prospective Cohort Study

Low Back Pain in Primary Care

Spine radiography in the evaluation of back and neck pain in an orthopaedic emergency clinic

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