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A Stratified Approach for Managing Patients With Low Back Pain in Primary Care (SPLIT Program): A Before-and-After Study.

2024Text Open access
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dc.contributor.authorGomes, Luís Antunes
dc.contributor.authorFernandes, Rita
dc.contributor.authorCaeiro, Carmen
dc.contributor.authorHenriques, Ana Rita
dc.contributor.authorSousa, Rute Dinis
dc.contributor.authorBranco, Jaime C
dc.contributor.authorPimentel-Santos, Fernando
dc.contributor.authorMoniz, Rubina
dc.contributor.authorVicente, Lilia
dc.contributor.authorCanhão, Helena
dc.contributor.authorRodrigues, Ana Maria
dc.contributor.authorCruz, Eduardo Brazete
dc.contributor.editorHighWire
dc.date.accessioned2025-02-20T16:10:12Z
dc.date.available2025-02-20T16:10:12Z
dc.date.issued2024
dc.description.abstractPurpose: To determine the effects of stratified primary care for low back pain (SPLIT program) in decreasing back-related disability for patients with low back pain (LBP) in primary care. Methods: We conducted a before-and-after study. We compared health-related outcomes for 2 sequential, independent cohorts of patients with LBP recruited at 7 primary care units in Portugal. The first prospective cohort study characterized usual care (UC) and collected data from February to September 2018. The second was performed when the SPLIT program was implemented and collected data from November 2018 to October 2021. Between cohorts, physical therapists were trained in the implementation of the SPLIT program, which used the STarT Back Screening Tool to categorize patients for matched treatment. We compared back-related disability (Roland-Morris Disability Questionnaire, 0-24 points), pain (Numeric Pain Rating Scale, 0-10 points), perceived effect of treatment (Global Perceived Effect Scale, -5 to +5 points), and health-related quality of life (EuroQoL 5 dimensions 3 levels index, 0-1 points). Results: We enrolled a total of 447 patients: 115 in the UC cohort (mostly treated with pharmacologic treatment) and 332 in the SPLIT cohort (all referred for a physical therapy intervention program). Over the study period of 6 months, patients in the SPLIT program showed significantly greater improvements in back-related disability (ß, -2.94; 95% CI, -3.63 to -2.24; P ≤ .001), pain (ß, -0.88; 95% CI, -1.18 to -0.57; P ≤ .001), perceived effect of treatment (ß, 1.40; 95% CI, 0.97 to 1.82; P ≤ .001), and health-related quality of life (ß, 0.11; 95% CI, 0.08 to 0.14; P ≤ .001) compared with UC. Conclusions: Patients in the SPLIT program for LBP showed greater benefits regarding health-related outcomes than those receiving UC.eng
dc.identifier.citationAnn Fam Med . 2024 May-Jun;22(3):195-202. doi: 10.1370/afm.3104.
dc.identifier.pmid38806277
dc.identifier.urihttp://hdl.handle.net/10400.17/5063
dc.language.isoeng
dc.peerreviewedyes
dc.publisherHighWire
dc.relationThis study was funded by the Fundação Ciência e Tecnolo gia, IP national support via the Comprehensive Health Research Centre (CHRC) (UIDP/04923/2020). Luís Antunes Gomes is supported by the same institution under an individual PhD grant (SFRH/BD/145636/2019)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAdult
dc.subjectAged
dc.subjectMale
dc.subjectControlled Before-After Studies
dc.subjectFemale
dc.subjectHumans
dc.subjectDisability Evaluation
dc.subjectLow Back Pain* / therapy
dc.subjectMiddle Aged
dc.subjectPain Measurement
dc.subjectPhysical Therapy Modalities
dc.subjectPortugal
dc.subjectPrimary Health Care*
dc.subjectQuality of Life
dc.subjectProspective Studie
dc.titleA Stratified Approach for Managing Patients With Low Back Pain in Primary Care (SPLIT Program): A Before-and-After Study.eng
dc.typetext
dspace.entity.typePublication
oaire.citation.endPage202
oaire.citation.issue3
oaire.citation.startPage195
oaire.citation.titleAnnals of Family Medicine
oaire.citation.volume22
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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