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Previous research showed that direct access to physiotherapy, and the associated early physiotherapeutic treatment of patients with low back pain (LBP), results in improved clinical outcomes, as well as reduced health-related costs. However, despite these results, the effectiveness of direct access to physiotherapy and its impact on costs has never been investigated in Belgium. Therefore, the goal of this study is to compare the (cost-)effectiveness of direct access to physiotherapy compared to usual care by the general practitioner (GP) for patients with acute LBP.
In this study, 600 patients with acute LBP (lasting >24 hours and <6 weeks) will be divided into two groups (Dutch-speaking: n=2x150; French-speaking n= 2x150). One group will receive treatment through direct access to the physiotherapist, without prescription by a GP. The other group will follow the traditional care pathway through the GP. Th effects on pain, disability and cost-effectiveness will be analysed using questionnaires obtained before and at the end of treatment, after 3 months, after one and after two years. Primary outcomes include pain and disability. Secondary outcomes include clinical outcomes, beliefs related to LBP, quality of life, patient satisfaction, but also direct health care costs, health care resource use, as well as absenteeism and productivity loss.
The results of this study will answer the question whether direct access to physiotherapy is (cost)effective for acute LBP. In the long term, these results might be used to optimize the care pathway in Belgium for patients with acute low back pain.
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Inclusion criteria
Patients with non-specific acute LBP defined as (based on Nicol et al. 2020):
looking for LBP care for the first time in case of first episode, OR for the first time for the current episode in case of recurrent or persistent LBP
lasting > 24 hours and < 6 weeks
with an average pain intensity during the past 24 hours of ≥ 3 on an 11-point Numerical Pain Rating Scale
with an Oswestry Disability Index score (version 2.1a) of at least 20% (Denteneer et al. 2018).
Patients aged between 18 and 65 years
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Interventional model
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600 participants in 2 patient groups
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Central trial contact
Pieter Severijns, PhD; Lotte Janssens, PhD
Data sourced from clinicaltrials.gov
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