IMPaCT Back study protocol. Implementation of subgrouping for targeted treatment systems for low back pain patients in primary care: a prospective population-based sequential comparison

BMC Musculoskeletal Disorders

Study Protocol

Elaine M Hay¹  Martyn Lewis¹  Nadine E Foster¹  Julie Young¹  Carol Doyle²  David Whitehurst³  Ricky Mullis⁴ 

[1] Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, ST5 5BG, Staffordshire, UK;Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, ST5 5BG, Staffordshire, UK;Central and Eastern Cheshire Primary Care Trust, Universal House, Middlewich, Cheshire, UK;Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, ST5 5BG, Staffordshire, UK;Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, UK;General Practice & Primary Care Research Unit, Department of Public Health & Primary Care, University of Cambridge, UK;

关键词: National Health Service;    Health Care Practitioner;    Primary Care Trust;    Normalisation Process Theory;    Quality Improvement Intervention;   

DOI  :  10.1186/1471-2474-11-186

 received in 2010-07-27, accepted in 2010-08-20,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundPrognostic assessment tools to identify subgroups of patients at risk of persistent low back pain who may benefit from targeted treatments have been developed and validated in primary care. The IMPaCT Back study is investigating the effects of introducing and supporting a subgrouping for targeted treatment system in primary care.Methods/DesignA prospective, population-based, quality improvement study in one Primary Care Trust in England with a before and after design. Phases 1 and 3 collect data on current practice, attitudes and behaviour of health care practitioners, patients' outcomes and health care costs. Phase 2 introduces and supports the subgrouping for targeted treatment system, via a multi-component, quality improvement intervention that includes educational courses and outreach visits led by opinion leaders, audit/feedback, mentoring and organisational support to embed the subgrouping tools within IT and clinical management systems.We aim to recruit 1000 low back pain patients aged 18 years and over consulting 7 GP practices within one Primary Care Trust in England, UK. The study includes GPs in participating practices and physiotherapists in associated services. The primary objective is to determine the effect of the subgrouping for targeted treatment system on back pain related disability and catastrophising at 2 and 6 months, comparing data from phase 1 with phase 3. Key secondary objectives are to determine the impact on:a) GPs' and physiotherapists' attitudes and behaviour regarding low back pain;b) The process of care that patients receive;c) The cost-effectiveness and sustainability of the new clinical system.DiscussionThis paper details the rationale, design, methods, planned analysis and operational aspects of the IMPaCT Back study. We aim to determine whether the new subgrouping for targeted treatment system is implemented and sustained in primary care, and evaluate its impact on clinical decision-making, patient outcomes and costs.Study registrationInternational Standard Randomised Controlled Trial Number Register ISRCTN55174281

【 授权许可】

CC BY   
© Foster et al; licensee BioMed Central Ltd. 2010