Referral Source and Outcomes of Physical Therapy Care in Patients With Low Back Pain

Brooks, Gary; Dolphin, Michelle; Vanbeveren, Patrick; Hart, Dennis L.

doi:10.2519/jospt.2012.3957

Cited by 7 publications

(10 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, specific diagnoses of LBP, spinal surgeries, injections, multiple tests and the level of chronicity of LBP could also influence the rate of referral to physiotherapy. 16,32…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Health professionals’ referral practice and related healthcare utilization for people with low back pain in Singapore: A retrospective study

Loy

Yang

Chemat

et al. 2019

Hong Kong Physiother. J.

View full text Add to dashboard Cite

Background: Low back pain is a common musculoskeletal disorder that can incur high financial burden. A significant proportion of this burden may be incurred from referrals to health services and subsequent healthcare usages. Patients’ overall experience of pain and its related life interferences may also have some relevance to this usage. Objective: This study aimed to examine the referral practices and subsequent health service utilization of patients with LBP within a tertiary specialist clinic setting. A secondary objective was to explore potential associations between primary independent variables of pain and life interferences with health service utilization. Methods: Participants were patients with low back pain, who completed a set of self-reported low back pain measures. These included measures for pain intensity, pain interference, disability and quality of life. The participants’ back pain-related referral and health service utilization in the subsequent 12 months were recorded. Results: A total of 282 patients completed the full measures. Of these, 59.9% were referred for physiotherapy, 26.3% for diagnostic imaging and 9.2% for interventional procedures. Compared to patients who were referred from tertiary care, those from primary care had lower pain intensity ([Formula: see text]), pain interference ([Formula: see text]), disability ([Formula: see text]), but better physical and mental quality of life ([Formula: see text], [Formula: see text]). High pain interference was a common factor among patients who were referred on to other services after first consultation. Levels of medical utilization and physiotherapy utilization were both associated with pain intensity ([Formula: see text], [Formula: see text] vs [Formula: see text], [Formula: see text]), pain interference ([Formula: see text], [Formula: see text] vs [Formula: see text], 0.01) and disability ([Formula: see text], [Formula: see text] vs [Formula: see text], [Formula: see text]). Regression analysis showed that the source of referral contributed to 6% of the variance in medical utilization and 3% of the variance in physiotherapy utilization. After controlling the demographic variables and referral sources, none of the independent variables added any significant variance to medical utilization. Only pain intensity contributed an additional 2% variance to physiotherapy utilization. Conclusion: Referral patterns and practices appear similar to those reported in other studies. Higher levels of pain intensity, interference, disability and quality of life appear to influence the referral to different health services and subsequent treatment utilization.

show abstract

“…In addition, specific diagnoses of LBP, spinal surgeries, injections, multiple tests and the level of chronicity of LBP could also influence the rate of referral to physiotherapy. 16,32…”

Section: Discussionmentioning

confidence: 99%

“…19,34 Physiotherapy utilization 4.81 false(SD=4.53false) was lower compared to the 8.4 and 10.3 visits reported in tertiary settings. 32,35…”

Section: Discussionmentioning

confidence: 99%

Health professionals’ referral practice and related healthcare utilization for people with low back pain in Singapore: A retrospective study

Loy

Yang

Chemat

et al. 2019

Hong Kong Physiother. J.

View full text Add to dashboard Cite

show abstract

“…The search revealed one pragmatic randomised control trial [17], 14 observational retrospective studies [10,15,16,18,[21][22][23][24][25][26][28][29][30][31], five observational prospective studies [13,14,19,20,27], one prospective quasi-experimental study [12], and two audits [11,32]. Two studies used a low sample size (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…A total of nine studies evaluated referral pathways within Intermediate Care, including experienced physiotherapist referral, level of agreement between physiotherapist and orthopaedic consultant [24][25][26][27], role in reducing waiting times [28][29][30], referrals from a sports and exercise medicine department [31], and referrals led by an extended scope physiotherapist [32]. Fig.…”

Section: Type Of Studiesmentioning

confidence: 99%

“…The modified checklist ranked the observational studies into three sub-levels of evidence; high (score = 13 to 16), medium (score = 9 to 12) and low (score ≤ 8). The modified checklist revealed 11 low [10,12,18,20,21,[25][26][27][28][29][30], eight medium [11,15,16,19,22,23,31,32], and four high quality studies [13,14,17,24].…”

Section: Quality Assessment Scoresmentioning

confidence: 99%

See 1 more Smart Citation

Intermediate Care pathways for musculoskeletal conditions – Are they working? A systematic review

et al. 2015

View full text Add to dashboard Cite

The effectiveness of post‐professional physical therapist training in the treatment of chronic low back pain using a propensity score approach with machine learning

Cheema

Baldwin

Rodeghero

et al. 2022

Musculoskeletal Care

View full text Add to dashboard Cite

Rationale: Low back pain (LBP) is a leading cause of disability in the United States creating substantial hardships through negative social, financial, and health effects. Chronic low back pain (CLBP) accounted for above half of patients treated in physical therapy (PT) clinics for LBP. However, research shows small benefit from PT in CLBP treatment. Preliminary evidence suggests clinician-level training variables may affect outcomes, but requires further investigation to determine whether patients with CLBP benefit from treatment by providers with post-professional training. This study examined the relationship between clinician training levels and patient-reported outcomes in CLBP treatment.Methods: Physical therapies were surveyed using a large patient outcome assessment system to determine and categorise them by level of post-professional education. To account for the possibility that clinicians with higher levels of training are referred more-complex patients, a machine learning approach was used to identify predictive variables for clinician group, then to construct propensity scores to account for differences between groups. Differences in functional status score change among pooled data were analysed using linear models adjusted for propensity scores.Results: There were no clinically meaningful differences in patient outcomes when comparing clinician post-professional training level. The propensity score method proved to be a valuable way to account for differences at baseline between groups. Conclusion:Post-professional training does not appear to contribute to improved patient outcomes in the treatment of CLBP. This study demonstrates that propensity score analysis can be used to ensure that differences observed are true and not due to differences at baseline.

show abstract

Referral Source and Outcomes of Physical Therapy Care in Patients With Low Back Pain

Cited by 7 publications

References 37 publications

Health professionals’ referral practice and related healthcare utilization for people with low back pain in Singapore: A retrospective study

Health professionals’ referral practice and related healthcare utilization for people with low back pain in Singapore: A retrospective study

Intermediate Care pathways for musculoskeletal conditions – Are they working? A systematic review

The effectiveness of post‐professional physical therapist training in the treatment of chronic low back pain using a propensity score approach with machine learning

Contact Info

Product

Resources

About