Open this publication in new window or tab >>Finnish Institute of Occupational Health, Oulu, Finland.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Spine and Mind Fysio, Odense, Denmark; Spine Center of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark.
Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland.
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Mehiläinen Corporation, Oulu, Finland.
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Työterveys Virta Oy, Oulu, Finland.
Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine.
Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine.
Department of Law, Psychology, and Social Work, Center for Health and Medical Psychology, Örebro University, Örebro, Sweden.
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia; Body Logic Physiotherapy, Perth, Western Australia, Australia.
Centre for Health and Social Economics, Finnish Institute for Health and Welfare, Helsinki, Finland.
Show others...
2021 (English)In: Health Science Reports, E-ISSN 2398-8835, Vol. 4, no 1, article id e251Article in journal (Refereed) Published
Abstract [en]
Background
To prevent low back pain (LBP) from developing into a prolonged disabling condition, clinical guidelines advocate early stage assessment, risk‐screening, and tailored interventions. Occupational health services recommend guideline‐oriented biopsychosocial screening and individualized assessment and management. However, it is not known whether training a limited number of health care professionals improves the management process. The primary objective of this study is to investigate whether training in the biopsychosocial practice model is effective in reducing disability. Furthermore, we aim to evaluate health‐economic impacts of the training intervention in comparison to usual medical care.
Methods
The occupational health service units will be allocated into a training or control arm in a two‐arm cluster randomized controlled design. The training of occupational physiotherapists and physicians will include the assessment of pain‐related psychosocial factors using the STarT Back Tool and the short version of the Örebro Musculoskeletal Pain Screening Questionnaire, the use of an evidence‐based patient education booklet as part of the management of LBP, and tailored individualized management of LBP according to risk stratification. The control units will receive no training. The study population will include patients aged 18–65 with nonspecific LBP. The primary outcome is a patient‐reported Oswestry Disability Index from baseline to 12 months. By estimating group differences over time, we aim to evaluate the effectiveness of the training intervention in comparison to usual medical care, and to undertake an economic evaluation using individual patients' health care records (participant‐level data) and the participating units' registries (cluster‐level data). In addition, through interviews and questionnaires, we will explore the health care professionals' conceptions of the adoption of, the barriers to, and the facilitators of the implementation of the practice model.
Discussion
The evaluation of training in the guideline‐oriented biopsychosocial management of LBP in occupational health services is justified because LBP represents an enormous burden in terms of work disability.
Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
biopsychosocial approach, cluster randomized controlled study, implementation research, lowback pain, occupational health services, Örebro musculoskeletal pain screening questionnaire, risk stratification, STarT Back tool
National Category
Clinical Medicine Health Sciences
Identifiers
urn:nbn:se:liu:diva-174213 (URN)10.1002/hsr2.251 (DOI)000672475300033 ()33728382 (PubMedID)2-s2.0-85102066194 (Scopus ID)
Note
Funding: Finnish Work Environment Fund [117139/2017]; Finnish Institute of Occupational Health; Rokua Health and Rehabilitation Foundation; Finnish Cultural FoundationFinnish Cultural FoundationFinnish IT center for science; University of Oulu, Oulu, Finland; Finnish Work Environment Fund
2021-03-162021-03-162023-12-28Bibliographically approved