• Trials · Jun 2018

    The effectiveness of a stratified care model for non-specific low back pain in Danish primary care compared to current practice: study protocol of a randomised controlled trial.

    • Lars Morso, Berit Schiøttz-Christensen, Jens Søndergaard, AndersenNils-Bo de VosNVDepartment for Health Provision, Region of Central Denmark, Viborg, Denmark., Flemming Pedersen, Kim Rose Olsen, Morten Sall Jensen, Jonathan Hill, and David Høyrup Christiansen.
    • Centre for Quality, Region of Southern Denmark, P.V. Tuxensvej 5, 5500, Middelfart, Denmark. lars.morsoe@rsyd.dk.
    • Trials. 2018 Jun 8; 19 (1): 315.

    BackgroundPrior studies indicate that stratified care for low back pain results in better clinical outcome and reduced costs in healthcare compared to current practice. Stratified care may be associated with clinical benefits for patients with low back pain at a lower cost, but evidence is sparse. Hence this study aims to evaluate the clinical effects and cost-effectiveness of stratified care in patients with non-specific low back pain compared to current practice.Methods/DesignThe study is a two-armed randomised controlled trial in primary care in the Regions of Southern and Central Denmark (2.5 million citizens). Patients with non-specific low back will be recruited by paticpating GPs. Patients are randomised to either (1) stratified care or (2) current practice at participating physiotherapy clinics. In the stratified care arm, the intervention is based on the patient's STarT Back Tool classification and trained accordingly, whereas physiotherapists in the current pratice arm are blinded to the STarT score. Primary outcomes in the trial will be group differences in time off work, improvement in LBP disability measured by the Roland Morris Disability Questionnaire (RMDQ) and patient-reported global change. Secondary measures will be pain intensity, patient satisfaction, data on patient healthcare resource utilisation and quality-adjusted life year based on the EQ-5D-5L.DiscussionStratified care that effectively targets treatment to relevant sub-groups of patients has potentially great impact on the treatment pathways of low back pain. Thus, if effective, this could result in better patient outcomes and at the same time reduce the costs for treatment of low back pain.Trial RegistrationClinicalTrials.gov , NCT02612467 . Registered on 16 November 2015.

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