On a global scale, back pain ranks sixth among all health problems in terms of contribution to disability. It is estimated that 6% to 9% of adults see their GP about back pain each year, which represents 14% of all consultations. In addition, back pain is among the top reasons for work absence. According to a new study by the Arthritis Research UK Primary Care Centre at Keele University, GP adoption of a stratified care approach results in significant benefits for patients suffering from back pain and reduces work absence by 50%.
The research team also established that stratified care was effective in reducing the proportion of patients given sickness certificates: the reduction amounts to 30% when compared to back pain sufferers receiving standard care. Equally important is the fact that the targeted approach does not lead to higher healthcare costs.
The results are based on an analysis of data for 922 patients suffering from low back pain. The information was provided by five GP practices based in Cheshire. The patients receiving stratified care were divided into groups through the use of a prognostic screening tool called STarT Back. This is a recently developed questionnaire featuring nine items and GPs give it to their patients during consultation. On the basis of this questionnaire, patients were assigned to one of three groups according to their permanent disability risk: low, medium and high. They were then prescribed risk-appropriate treatment and that resulted in improved physical function, greater care satisfaction and lower work absence. In addition, patients were given fewer non-steroidal anti-inflammatory drugs and reported greater satisfaction with the results of their care.