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01-12-2021 | Care | Study protocol

Effectiveness of a coordinated support system linking public hospitals to a health coaching service compared with usual care at discharge for patients with chronic low back pain: protocol for a randomised controlled trial

Authors: Emma K. Ho, Manuela L. Ferreira, Adrian Bauman, Paul W. Hodges, Christopher G. Maher, Milena Simic, Rachael L. Morton, Chris Lonsdale, Qiang Li, Melissa T. Baysari, Anita B. Amorim, Dragana Ceprnja, Ornella Clavisi, Mark Halliday, Matthew Jennings, Alice Kongsted, Katherine Maka, Kate Reid, Tahlia Reynolds, Paulo H. Ferreira

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Although many people with chronic low back pain (LBP) improve following conservative treatment, one in five will experience worsening symptoms after discharge from treatment and seek health care again. The current LBP clinical care pathway in many health services lacks a well-integrated, systematic approach to support patients to remain physically active and self-manage their symptoms following discharge from treatment. Health coaching can support people to improve physical activity levels and may potentially reduce health care utilisation for LBP. The primary aim of this study is to evaluate the effect of introducing a coordinated support system (linking hospital outpatient physiotherapy services to a public health coaching service) at discharge from LBP treatment, on the future use of hospital, medical, and health services for LBP, compared with usual care provided at discharge.

Methods

Three hundred and seventy-four adults with chronic non-specific LBP will be recruited from the outpatient physiotherapy departments of public hospitals in New South Wales, Australia. Participants will be individually randomised to a support system (n = 187) or usual care group (n = 187). All participants will receive usual care provided at discharge from treatment. Participants allocated to the support system will also receive up to 10 telephone-based health coaching sessions, delivered by the Get Healthy Service®, over a 6-month period. Health coaches will monitor and support participants to improve physical activity levels and achieve personal health-related goals. The primary outcome is the total number of encounters with hospital, medical, and health services for LBP, at 12 months from baseline. A within-trial economic evaluation will quantify the incremental costs and benefits of the support system from a health system perspective, to support reimbursement decision making.

Discussion

This study will establish the effect of a coordinated support system, introduced at discharge from treatment, on the future use of hospital, medical, and health services for LBP and various health outcomes.

Conclusion

Innovative community-driven solutions to support people with chronic LBP after discharge from treatment are urgently needed. Study findings will help inform health care policy and clinical practice in Australia.

Trial Registration

Prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12620000889954) on 10/09/2020.

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Title: Effectiveness of a coordinated support system linking public hospitals to a health coaching service compared with usual care at discharge for patients with chronic low back pain: protocol for a randomised controlled trial
Authors: Emma K. Ho
Manuela L. Ferreira
Adrian Bauman
Paul W. Hodges
Christopher G. Maher
Milena Simic
Rachael L. Morton
Chris Lonsdale
Qiang Li
Melissa T. Baysari
Anita B. Amorim
Dragana Ceprnja
Ornella Clavisi
Mark Halliday
Matthew Jennings
Alice Kongsted
Katherine Maka
Kate Reid
Tahlia Reynolds
Paulo H. Ferreira
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Care
Back Pain
Back Pain
Back Pain
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04479-z

At a glance: The STEP trials

Springer Medicine

Effectiveness of a coordinated support system linking public hospitals to a health coaching service compared with usual care at discharge for patients with chronic low back pain: protocol for a randomised controlled trial

Abstract

Background

Methods

Discussion

Conclusion

Trial Registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Discussion

Conclusion

Trial Registration

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