Budget Impact
If certain service delivery models are found to be more clinically and cost effective than the baseline model then an assessment of budget impact will be conducted to estimate the changes in resource use, costs and patient outcomes from moving from standard care to a regime with these models. The key uncertainty is likely to be the variation in existing practice. This should be informed by a questionnaire on current organisational practice.
Organisational Issues
To inform the cost-effectiveness analysis, the organisational issues associated with designing and streamlining services for the management of acute low back pain will be assessed via a separate Organisational Issues subgroup.
Potential question:
What is the evidence for the use of integrated communication systems/IT systems between primary and secondary care to improve the efficiency of a patient s journey for the management of low back pain?
Patient Issues
Patient issues will be explored specifically through a separate patient issues subgroup which will take place on February 21st, 2006. The research questions relating to patient issues will be defined thereafter and will be sent out on review to the HTA Topic group for their input.
Primary care
What barriers exist to the implementation by GPs of guidelines for the management of acute low back pain in primary care, and is there evidence for the effectiveness of interventions to overcome these barriers?
What strategies have been proposed to improve communication between GPs and patients with low back pain, and how effective are they in improving patient outcomes and patient and doctor satisfaction?
Is there evidence that educational interventions on pain management for primary care professionals improve outcomes among patients with low back pain managed in the community?
Analgesia
What evidence is there about how patients with low back pain use drugs prescribed for analgesia, i.e. are they used as prescribed, with regard to effectiveness, adverse effects and acceptability to patients?
Patient information
How can service providers in primary and secondary care and in the community best meet the information needs of people with low back pain?
Employment-focussed interventions
Is there evidence of a beneficial effect on health outcomes from work-focussed interventions delivered by health care providers in collaboration with employment services for people unable to work because of back pain? And is this associated with benefit to the NHS in terms of reduced health service use for back pain?
HTA Exclusions
This HTA will not include paediatric services for patients ≤ 16 years old.
As the HTA is focused on following a patient s journey from their first point of contact with primary care with acute low back pain ≤12 weeks, the HTA will exclude patients presenting for the fist time with chronic pain.
Additional Information
- Introduction
- Clinical Effectiveness Questions
- Cost Effectiveness Questions
- Other Issues
- Methodology
- Patient Pathways