Stratified Care of Low Back Pain course for Medical Doctors
Stratified care for back pain is about offering the right treatment to the right patient at the right time, thereby maximising treatment benefit, reducing harm and increasing healthcare efficiency.
Objectives
By the end of this session, you will be able to:
- Describe a stratified care approach for managing low back pain (STarT Back)
- Identify the constructs in the Keele STarT Back Screening Tool
- Select the appropriate matched treatment
- List the steps to implementation
Research comparing the effectiveness of different treatments for low back pain (LBP) over the last twenty years conclude either small or no differences in the average effects of different treatments. One suggestion to explain this is that patients are not all the same and important subgroups exist that might require different treatment approaches.
Gail is a consultant physiotherapist within the NHS and a research fellow at the Research Institute for Primary Care & Health Sciences, Keele University, UK. She is involved in world leading musculoskeletal research and supports the implementation of key research findings into policy and practice as a member of an Impact Accelerator Unit. She is the Midlands Partnership NHS Foundation Trusts’ Allied Health Professions lead for pain and provides leadership and clinical input to an award winning interdisciplinary pain service.
She leads and contributes to the development of nation policy and practice and is a National Institute for Health and Care Excellence (NICE) Fellow Alumni. She is the Chair of the BPS Pain Management Programme SIG and sits on the BPS Academic Scientific Committee. She publishes in peer reviewed journals, delivers post graduate clinical skills courses internationally and has presented at a number of international and national conferences.
Nadine is an NIHR Professor of Musculoskeletal Health in Primary Care at Keele University and the Director of Keele Clinical Trials Unit. She leads the Musculoskeletal Health and Pain research programme within the Arthritis Research UK Primary Care Centre in the Research Institute of Primary Care and Health Sciences and is an NIHR Senior Investigator.
Her primary research interest is in developing, testing and implementing treatments and services for patients with musculoskeletal pain. She has contributed to over £35 million in research funding, has led or collaborated on more than 19 randomised trials and currently leads an NIHR Programme Grant for Applied Research on stratified primary care for patients with musculoskeletal pain (STarT MSK) and an NIHR Health Technology Assessment (HTA) funded trial testing stratified care for patients consulting in primary care with sciatica (SCOPiC).
Nadine is the lead NIHR training advocate for physiotherapy and President of the Society of Back Pain Research. She chairs the NIHR Research for Patient Benefit funding panel in the West Midlands, and has previously served on HTA funding committees and the Arthritis Research UK Pain Clinical Studies Group
Jonathan is a senior lecturer in physiotherapy at the Research Institute for Primary Care and Health Sciences (iPCHS) at Keele University. He has worked as a clinical physiotherapist in a variety of settings and has maintained close links with clinicians through professional networks and roles with the UK Chartered Society of Physiotherapy.
He has experience of designing, conducting and reporting applied clinical research in musculoskeletal (MSK) conditions and in physiotherapy and general practice settings. His research methodological expertise includes cohort studies, mixed methods, systematic reviewing, feasibility studies and randomised controlled trials. He has a particular research interest in stratified care to better target treatment at the needs of patients, digital health interventions and the use of patient reported outcomes to improve the quality of MSK clinical services. He co-leads the Spinal Research Group at Keele and was the first author for the STarT Back Trial which was published in The Lancet (2011) and led to a step change in physiotherapy management of back pain (cited >800 times).
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