The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care.
<h4>Background</h4>Family physicians in Canada's universal healthcare system often manage low back pain patients using interventions not recommended in clinical guidelines, such as pharmaceuticals, imaging and spinal injections, while guideline-based treatments like education and ex...
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0312737 |
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| author | Brandyn Powelske Alice Kongsted Allyson Jones Gregory Kawchuk |
| author_facet | Brandyn Powelske Alice Kongsted Allyson Jones Gregory Kawchuk |
| author_sort | Brandyn Powelske |
| collection | DOAJ |
| description | <h4>Background</h4>Family physicians in Canada's universal healthcare system often manage low back pain patients using interventions not recommended in clinical guidelines, such as pharmaceuticals, imaging and spinal injections, while guideline-based treatments like education and exercise remain unfunded. The Alberta Back Care pathway was developed to address this gap, offering funded, evidence-based care for low back pain patients in 5 streams (acute, sub-acute, chronic, chronic non-responsive and stable radiculopathy).<h4>Objective</h4>To evaluate the feasibility of implementing the pathway in two urban Primary Care Networks in Alberta, Canada.<h4>Materials and methods</h4>Each of the 5 pathway streams provided physicians with information scripts, no-cost interventions (pharmaceuticals and otherwise) and interventions to avoid. From April 2021 to November 2023, the RE-AIM framework was used to assess implementation feasibility of the pathway.<h4>Results</h4>For the RE-AIM dimension of reach, 25% (n = 41/162) of eligible family physicians in Primary Care Network "A" and 12% (n = 26/221) in Primary Care Network "B" enrolled in the study. Over half of enrolled physicians (n = 21/41 and 21/26) referred at least one patient with most referrals to the GLA:D Back program for chronic low back pain stream (93% in network "A" and 88% in network "B"). Implementation, evaluated as the proportion of referrals by physician compared to their total low back pain caseload, was low (> 0-10% referred) for 52% (n = 11/21) of physicians in network "A", and medium-low (10-25% referred) for 52% (n = 11/21) of physicians in network "B". The number of pathway-appropriate patients in each physician's caseload was unknown. Maintenance at 12 months was 56% (n = 10/18) in network "A" and 39% (n = 7/18) in network "B".<h4>Conclusion</h4>The Alberta Back Care pathway was feasible to implement during the pandemic and primarily serving patients with chronic low back pain by providing access to a guideline-based education and exercise group program (GLA:D Back). |
| format | Article |
| id | doaj-art-39f2c4ad1492471b9ff5db47617b5d6b |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-39f2c4ad1492471b9ff5db47617b5d6b2024-12-04T05:31:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011911e031273710.1371/journal.pone.0312737The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care.Brandyn PowelskeAlice KongstedAllyson JonesGregory Kawchuk<h4>Background</h4>Family physicians in Canada's universal healthcare system often manage low back pain patients using interventions not recommended in clinical guidelines, such as pharmaceuticals, imaging and spinal injections, while guideline-based treatments like education and exercise remain unfunded. The Alberta Back Care pathway was developed to address this gap, offering funded, evidence-based care for low back pain patients in 5 streams (acute, sub-acute, chronic, chronic non-responsive and stable radiculopathy).<h4>Objective</h4>To evaluate the feasibility of implementing the pathway in two urban Primary Care Networks in Alberta, Canada.<h4>Materials and methods</h4>Each of the 5 pathway streams provided physicians with information scripts, no-cost interventions (pharmaceuticals and otherwise) and interventions to avoid. From April 2021 to November 2023, the RE-AIM framework was used to assess implementation feasibility of the pathway.<h4>Results</h4>For the RE-AIM dimension of reach, 25% (n = 41/162) of eligible family physicians in Primary Care Network "A" and 12% (n = 26/221) in Primary Care Network "B" enrolled in the study. Over half of enrolled physicians (n = 21/41 and 21/26) referred at least one patient with most referrals to the GLA:D Back program for chronic low back pain stream (93% in network "A" and 88% in network "B"). Implementation, evaluated as the proportion of referrals by physician compared to their total low back pain caseload, was low (> 0-10% referred) for 52% (n = 11/21) of physicians in network "A", and medium-low (10-25% referred) for 52% (n = 11/21) of physicians in network "B". The number of pathway-appropriate patients in each physician's caseload was unknown. Maintenance at 12 months was 56% (n = 10/18) in network "A" and 39% (n = 7/18) in network "B".<h4>Conclusion</h4>The Alberta Back Care pathway was feasible to implement during the pandemic and primarily serving patients with chronic low back pain by providing access to a guideline-based education and exercise group program (GLA:D Back).https://doi.org/10.1371/journal.pone.0312737 |
| spellingShingle | Brandyn Powelske Alice Kongsted Allyson Jones Gregory Kawchuk The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care. PLoS ONE |
| title | The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care. |
| title_full | The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care. |
| title_fullStr | The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care. |
| title_full_unstemmed | The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care. |
| title_short | The Alberta Back Care Pathway: The feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care. |
| title_sort | alberta back care pathway the feasibility of implementing a novel care pathway to improve low back pain management for family physicians in primary care |
| url | https://doi.org/10.1371/journal.pone.0312737 |
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