Skip to main content

Research Repository

Advanced Search

Risk-stratified and stepped models of care for back pain and osteoarthritis: are we heading towards a common model?

Hill, Jonathan

Risk-stratified and stepped models of care for back pain and osteoarthritis: are we heading towards a common model? Thumbnail


Authors



Abstract

The overall quality of care for musculoskeletal pain conditions is suboptimal, partly due to a considerable evidence-practice gap. In osteoarthritis and low back pain, structured models of care exist to help overcome that challenge. In osteoarthritis, focus is on stepped care models, where treatment decisions are guided by response to treatment, and increasingly comprehensive interventions are only offered to people with inadequate response to more simple care. In low back pain, the most widely known approach is based on risk stratification, where patients with higher predicted risk of poor outcome are offered more comprehensive care. For both conditions, the recommended interventions and models of care share many commonalities and there is no evidence that one model of care is more effective than the other. Limitations of existing models of care include a lack of integrated information on social factors, comorbid conditions, and previous treatment experience, and they do not support an interplay between health care, self-management, and community-based activities. Moving forwards, a common model across musculoskeletal conditions seems realistic, which points to an opportunity for reducing the complexity of implementation. We foresee this development will use big data sources and machine-learning methods to combine stepped and risk-stratified care and to integrate self-management support and patient-centred care to a greater extent in future models of care.

Acceptance Date Jul 2, 2020
Publication Date Sep 1, 2020
Publicly Available Date Mar 29, 2024
Journal Pain Reports
Print ISSN 2471-2531
Publisher Lippincott, Williams & Wilkins
Pages e843 - ?
DOI https://doi.org/10.1097/PR9.0000000000000843
Keywords Models of care; Osteoarthritis; Low back pain; Risk-stratified care; Stepped care; Decision making
Publisher URL https://journals.lww.com/painrpts/Fulltext/2020/10000/Risk_stratified_and_stepped_models_of_care_for.18.aspx

Files




You might also like



Downloadable Citations