Trust your back. Classification-based care for low back pain in primary care.

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

MKS Auditorium (Mikkeli)

Topic of the dissertation

Trust your back. Classification-based care for low back pain in primary care.

Doctoral candidate

MD Anna Sofia Simula

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research Unit of Health Sciences and Technology

Subject of study

Medicine

Opponent

Professor Jens Ivar Brox, University of Oslo

Custos

Professor Jaro Karppinen, University of Oulu

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Trust your back. Classification-based care for low back pain in primary care.

A combination of education for healthcare professionals, classification-based care using the SBT, and systematic use of the patient education booklet seems to bring value to LBP care in primary healthcare.
Low back pain (LBP), mostly a non-specific symptom, is a leading cause of years lived with disability: multiple biological, psychological, social and lifestyle factors lead to pain-related disability and use of healthcare. Evidence-based care for LBP comprises active treatments that address biopsychosocial factors and focus on improving functioning, self-management, education, and advice to stay active, also at work. The STarT Back Tool (SBT) and the Örebro Musculoskeletal Pain Screening Questionnaire Short Form (ÖMPSQ-SF) were created to enable easy and systematic identification of predictive psychosocial and symptom-related factors. The patient education booklet was designed to support evidence-based care and reduce inappropriate imaging.
The study aim was to evaluate the concordance of the SBT and ÖMPSQ-SF and the accumulation of psychiatric, psychological, lifestyle, and social risk factors in the high-risk groups of both questionnaires among population with LBP. We also aimed to translate and validate the patient education booklet. We separately assessed the effectiveness of the patient education booklet and the classification-based approach to LBP care in primary care and compared it to that of usual care.
SBT and ÖMPSQ-SF were compared in a population-based study using the Northern Finland Birth Cohort 1966. The preliminary evaluation of the patient education booklet was obtained using web-based questionnaires. A cluster randomised study evaluated the effectiveness of the patient education booklet, and a Benchmarking Controlled Trial evaluated the effectiveness of a classification-based approach to LBP care in primary care.
Individual psychological and social risk factors accumulated among the high-risk groups of the SBT and the ÖMPSQ-SF. The education booklet helped patients understand their pain, encouraged them to be physically active, decreased imaging and the number of LBP-related sick leave days. Although classification-based care did not seem to influence physical functioning in the long term, pain was alleviated more quickly, and the use of healthcare services and number of back-related sick leave days decreased in the intervention group.
Last updated: 14.11.2024