Milo Sewards & Heidi Ojha
Associate Professor at Temple University, USA
Title: Guideline adherent triage and management for low back pain
Biography
Biography: Milo Sewards & Heidi Ojha
Abstract
In primary care, low back pain is the second most frequent symptom-related cause for patient visits. Management of low back pain is increasingly relying on guideline discordant care, resulting in growing health care costs, and risks to the patient including iatrogenic harm. Recent evidence suggests the STarT back screening tool is a safe and effective strategy to guide management of low back pain in primary care. Although the Keele STarT back screening tool is frequently utilized in Europe, it is in its infancy in the United States. This presentation will assist attendees in how to serve as the point of patient contact and stratification with use of this screening tool, and will describe plans for future tool development. The beginning of the program will be instructional, outlining practice guidelines, the current large variability in guideline adherence, and will include how to administer and interpret results of the STarT tool to match interventions to the patient’s prognostic category. The second half of the presentation will focus on how clinicians, educators, and researchers, might transition from a biomedical approach to a biopsychosocial approach in managing low back pain, and barriers to implementing these practice guidelines in education, health care delivery, and policy. Potential solutions will be discussed through panel discussion and audience participation. Multiple patient case examples will illustrate decision-making on appropriate timing of referral, indications for imaging, guideline recommended pharmacological management, and use of biopsychosocial language to increase patients’ confidence in resuming activity. The session will end with sharing multiple resources to identify and/or train support personnel to implement this evidence based approach to primary care management of low back pain.
