Authors (including presenting author) :
Ng OYC
Affiliation :
West Kowloon General Outpatient Clinic, Family Medicine and Primary Care Department. Kowloon West Cluster
Introduction :
STarT Back Screening Tool (SMST) was used to stratify Non-specific Low back pain (LBP) patients at West Kowloon General Outpatient Clinic (WK-GOPC) so that they could (1) receive targeted Physiotherapy (PT) treatment according to their conditions, (2) be triaged back to hospital PT for appropriate care, or referred back to physicians for further investigation and management.
Objectives :
To review the use of physiotherapy stratified care approach on non-specific back pain patients management under GOPC setting
Methodology :
In the first PT session, assessments and back exercises education were done, and patients were required to complete SBST, Numeric Pain Rating Scale (NPRS) and Roland Morris Disability Questionnaire (RMDQ). Follow-up appointment was booked for indicated patients for home exercise monitoring and re-assurance of self-management skills.
Result & Outcome :
Period of the review was from Oct 2017 to Dec 2020. A total 265 non-specific LBP patients, 96 men and 169 women attended first PT session, with mean age 55 [SD 12.3] (range 20 to 83 year of age). SBST classified non-specific LBP patients in low / medium / high risk-group. It was found that low risk-group constituted highest proportion (56%; n=149) vs medium risk-group 25% (n=66) and high risk-group 19% (n=50). Pain level (NPRS) and functional disability level (RMDQ) in three different groups were significantly improved (p< 0.01). Number of PT sessions was lowest in low risk-group 2.2 [SD 1.1] vs medium risk-group 2.9 [SD 1.1] and high risk-group 3.1 [SD 1.7]. 42% of high risk-group patients, 14% of medium risk-group patients (n=9) and 1% low risk-group patients (n=2) were referred back to hospital PT or physicians. Conclusion: SBST helps GOPC PT in classifying LBP patients. GOPC PT also plays a role in triage indicated patients to hospital PT for more intensive physical and psychosocial interventions, and acts as a gatekeeper in referring back to physicians for further investigation and management.
