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AbstractSubgrouping patients with low back pain in primary care: are we getting any better at it?Dr Nadine E FosterLow back pain is a common, disabling condition with high personal and economic costs. Despite available guidelines for practice, there have not been tangible reductions in the population prevalence of back pain or its serious long-term consequences. One reason for this, that has received increasing research attention, is that the ‘one size fits all approach’ advocated by many guidelines fails to target treatments at patients who might benefit from them most, thus diluting their potential benefits. Systematic identification of key obstacles to recovery in primary care back pain patients from high quality epidemiological studies can inform the development of early, targeted interventions. Indeed, maximising the potential for optimally targeted interventions is predicated on better understanding of the prognostic factors that are causally related to clinical outcome and identifying which are a) most predictive of outcome and b) most likely to be modifiable in primary care. Only then can closer matching of treatments to patient characteristics be a clinical reality. Using specific examples drawn from recent research within the Arthritis Research Campaign National Primary Care Centre at Keele University in the UK, and other studies, this presentation will provide an overview of subgrouping approaches under investigation, provide new evidence about the predictive strength of obstacles to recovery and share experience from studies that focus on translating subgrouping approaches into workable sytems in primary care clinical practice. Clinical Take Home Messages:
Acknowledgements: Research support from the Arthritis Research Campaign (arc), the National Institute of Health Research (NIHR) and the Health Foundation. Nadine Foster is funded by a Primary Care Career Scientist Award from the NIHR in the UK. |
