SRF004: Advancing team-based primary care for the management of chronic low back pain: a protocol for a multiple methods study
Kyle Vader, MSc, PT
Context: Chronic low back pain is among the leading contributors to disability, high health care costs, and is one of the most common reasons for seeking health care. In Canada, the patient centred medical home is being increasingly recognized as an approach to primary care. Although the patient centred medical home is becoming more common, there are still important research gaps that need to be addressed in order to optimize the management of chronic low back pain in this practice setting. Objectives: This research will address the following objectives: (1) Understand the experiences of adults with chronic low back pain related to accessing team-based primary care for the management of their pain; (2) understand health care provider experiences, barriers and/or facilitators, and recommendations to providing team-based primary care for the management of individuals with chronic low back pain; and (3) determine which social determinants of health predict pain-related disability in a sample of adults seeking care for chronic low back pain within team-based primary care. Study Design: These objectives will be addressed through three parallel research studies, including: (Study 1) an interpretive phenomenological analysis (Objective 1); (Study 2) an interpretive description study (Objective 2); and (Study 3) a cross-sectional study (Objective 3). Setting: Team-based primary care sites (Family Health Teams and Community Health Centres) within Ontario, Canada. Population Studied: Adults (18 years of age and older) with chronic low back pain as well as interprofessional health care providers (physicians, nurses, occupational therapists, social workers, physiotherapists, etc.) within team-based primary care sites. Intervention/Instrument: N/A. Outcome Measures: A semi-structured interview guide as well as focus group script will be used for studies one and two. For study three, various questions and outcome measures will be used to measure social determinants of health, while pain-related disability will be measured with the Rolland Morris Disability Questionnaire. Results: At the time of presentation, we will report on initial progress of this study with regards to participant recruitment and analysis. Expected Outcomes: This research will provide foundational knowledge and illuminate areas for future research to improve how team-based primary care is delivered for patients with chronic low back pain in the patient centred medical home.