TY - JOUR
T1 - Low back pain management in primary healthcare
T2 - findings from a scoping review on models of care
AU - Duarte, Susana Tinoco
AU - Moniz, Alexandre
AU - Costa, Daniela
AU - Donato, Helena
AU - Heleno, Bruno
AU - Aguiar, Pedro
AU - Cruz, Eduardo B.
N1 - Funding Information:
This project is supported by FCT\u2014Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia, I.P., under the PhD grant awarded to STD (UI/BD/150882/2021) and the MyBack project (PTDC/SAU-SER/7406/2020), in which EBC is the principal investigator.
Publisher Copyright:
© 2024 BMJ Publishing Group. All rights reserved.
PY - 2024/5/15
Y1 - 2024/5/15
N2 - Introduction Models of care (MoCs) describe evidence-informed healthcare that should be delivered to patients. Several MoCs have been implemented for low back pain (LBP) to reduce evidence-to-practice gaps and increase the effectiveness and sustainability of healthcare services. Objective To synthesise research evidence regarding core characteristics and key common elements of MoCs implemented in primary healthcare for the management of LBP. Design Scoping review. Data sources Searches on MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, PEDro, Scopus, Web of Science and grey literature databases were conducted. Eligibility criteria Eligible records included MoCs implemented for adult LBP patients in primary healthcare settings. Data extraction and synthesis Data extraction was carried out independently by two researchers and included a summary of the studies, the identification of the MoCs and respective key elements, concerning levels of care, settings, health professionals involved, type of care delivered and core components of the interventions. Findings were investigated through a descriptive qualitative content analysis using a deductive approach. Results 29 studies reporting 11 MoCs were included. All MoCs were implemented in high-income countries and had clear objectives. Ten MoCs included a stratified care approach. The assessment of LBP patients typically occurred in primary healthcare while care delivery usually took place in community-based settings or outpatient clinics. Care provided by general practitioners and physiotherapists was reported in all MoCs. Education (n=10) and exercise (n=9) were the most common health interventions. However, intervention content, follow-ups and discharge criteria were not fully reported. Conclusions This study examines the features of MoCs for LBP, highlighting that research is in its early stages and stressing the need for better reporting to fill gaps in care delivery and implementation. This knowledge is crucial for researchers, clinicians and decision-makers in assessing the applicability and transferability of MoCs to primary healthcare settings.
AB - Introduction Models of care (MoCs) describe evidence-informed healthcare that should be delivered to patients. Several MoCs have been implemented for low back pain (LBP) to reduce evidence-to-practice gaps and increase the effectiveness and sustainability of healthcare services. Objective To synthesise research evidence regarding core characteristics and key common elements of MoCs implemented in primary healthcare for the management of LBP. Design Scoping review. Data sources Searches on MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, PEDro, Scopus, Web of Science and grey literature databases were conducted. Eligibility criteria Eligible records included MoCs implemented for adult LBP patients in primary healthcare settings. Data extraction and synthesis Data extraction was carried out independently by two researchers and included a summary of the studies, the identification of the MoCs and respective key elements, concerning levels of care, settings, health professionals involved, type of care delivered and core components of the interventions. Findings were investigated through a descriptive qualitative content analysis using a deductive approach. Results 29 studies reporting 11 MoCs were included. All MoCs were implemented in high-income countries and had clear objectives. Ten MoCs included a stratified care approach. The assessment of LBP patients typically occurred in primary healthcare while care delivery usually took place in community-based settings or outpatient clinics. Care provided by general practitioners and physiotherapists was reported in all MoCs. Education (n=10) and exercise (n=9) were the most common health interventions. However, intervention content, follow-ups and discharge criteria were not fully reported. Conclusions This study examines the features of MoCs for LBP, highlighting that research is in its early stages and stressing the need for better reporting to fill gaps in care delivery and implementation. This knowledge is crucial for researchers, clinicians and decision-makers in assessing the applicability and transferability of MoCs to primary healthcare settings.
KW - back pain
KW - health services
KW - musculoskeletal disorders
KW - organisation of health services
KW - pain management
KW - primary health care
UR - http://www.scopus.com/inward/record.url?scp=85193432797&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2023-079276
DO - 10.1136/bmjopen-2023-079276
M3 - Article
C2 - 38754873
AN - SCOPUS:85193432797
SN - 2044-6055
VL - 14
JO - BMJ Open
JF - BMJ Open
IS - 5
M1 - e079276
ER -