The SelfSTarT intervention for low back pain patients presenting to first contact physiotherapists: A mixed methods service evaluation

Author:

Stevenson K.12ORCID,Hadley‐Barrows T.13,Evans N.1,Campbell L.1,Southam J.1,Chudyk A.1,Ellington D.2ORCID,Jeeves B.2,Jenson C.4,Kleberg S.4,Birkinshaw H.1,Mair F.5,Dziedzic K.1,Peat G.6,Jordan K. P.1,Yu D.1,Bailey J.1,Braybooke A.1ORCID,Mallen C. D.1,Hill Jonathan C.1

Affiliation:

1. School of Medicine Primary Care Centre Versus Arthritis Keele University Keele Staffordshire UK

2. Midlands Partnership University Foundation NHS Trust Haywood Hospital Keele Staffordshire UK

3. Royal Wolverhampton NHS Trust Wolverhampton UK

4. SelfBack Company Odense Denmark

5. Glasgow University Glasgow UK

6. Centre for Applied Health & Social Care Research (CARe) Sheffield Hallam University Sheffield UK

Abstract

AbstractIntroductionGlobally, back pain is the leading cause of years of disability. In the United Kingdom, over 20 million people live with musculoskeletal (MSK) pain, with low back pain being one of the most common causes. National strategies promote self‐management and the use of digital technologies to empower populations.AimsTo evaluate the uptake and impact of providing the SelfSTart approach (STarT Back and SelfBACK App) when delivered by a First Contact Physiotherapist (FCP) to people presenting with low back pain in primary care.MethodsPatients presenting with a new episode of low back pain underwent routine assessment and completion of a STarT Back questionnaire. Patients with low/medium scores were offered the SelfBACK App. A control population was provided by the MIDAS‐GP study. Patient Experience, outcome measures, healthcare utilisation and retention were captured through the app and clinical systems (EMIS). Interviews with five FCPs explored the experiences of using the SelfSTart approach.ResultsSelfSTarT was taken up by almost half (48%) of those to whom it was offered. Compared to MIDAS‐GP, users were more likely to be younger, male, in work, and with higher health literacy. SelfSTarT users reported significant improved experiences relating to receiving an agreed care plan and receiving sufficient information. There were no significant differences in treatments offered. FCPs were positive about the app and felt it had value but wanted feedback on patient progress. They recognised that a digital solution would not be suitable for all.ConclusionThis approach offers an opportunity to empower and support self‐management, using robustly evaluated digital technology.

Funder

Nuffield Foundation

Publisher

Wiley

Reference29 articles.

1. Department of Health and Social Care. (2023).Major conditions strategy: Case for change and our strategic framework. Retrieved fromhttps://www.gov.uk/government/publications/major‐conditions‐strategy‐case‐for‐change‐and‐our‐strategic‐framework/major‐conditions‐strategy‐case‐for‐change‐and‐our‐strategic‐framework‐‐2#chapter‐4‐living‐with‐major‐conditions. Accessed 5/10/2023.

2. Department of Health. (2006).The musculoskeletal services framework. A joint responsibility: Doing it differently. Retrieved fromhttps://webarchive.nationalarchives.gov.uk/20130124073659/

3. Effect of Stratified Care for Low Back Pain in Family Practice (IMPaCT Back): A Prospective Population-Based Sequential Comparison

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