The SelfSTarT intervention for low back pain patients presenting to first contact physiotherapists: A mixed methods service evaluation

Stevenson, Kay; Hadley‐Barrows, T.; Evans, N.; Campbell, L.; Southam, J.; Chudyk, A.; Ellington, Dominic; Jeeves, B.; Jenson, C.; Kleberg, S.; Birkinshaw, H.; Mair, F.; Dziedzic, K.; Peat, G.; Jordan, K. P.; Yu, D.; Bailey, J.; Braybooke, A.; Mallen, C. D.; Hill, Jonathan C.

Abstract

Introduction
Globally, back pain is the leading cause of years of disability. In the United Kingdom, over 20 million people live with musculoskeletal (MSK) pain, with low back pain being one of the most common causes. National strategies promote self-management and the use of digital technologies to empower populations.

Aims
To evaluate the uptake and impact of providing the SelfSTart approach (STarT Back and SelfBACK App) when delivered by a First Contact Physiotherapist (FCP) to people presenting with low back pain in primary care.

Methods
Patients presenting with a new episode of low back pain underwent routine assessment and completion of a STarT Back questionnaire. Patients with low/medium scores were offered the SelfBACK App. A control population was provided by the MIDAS-GP study. Patient Experience, outcome measures, healthcare utilisation and retention were captured through the app and clinical systems (EMIS). Interviews with five FCPs explored the experiences of using the SelfSTart approach.

Results
SelfSTarT was taken up by almost half (48%) of those to whom it was offered. Compared to MIDAS-GP, users were more likely to be younger, male, in work, and with higher health literacy. SelfSTarT users reported significant improved experiences relating to receiving an agreed care plan and receiving sufficient information. There were no significant differences in treatments offered. FCPs were positive about the app and felt it had value but wanted feedback on patient progress. They recognised that a digital solution would not be suitable for all.

Conclusion
This approach offers an opportunity to empower and support self-management, using robustly evaluated digital technology.

Citation

Stevenson, K., Hadley‐Barrows, T., Evans, N., Campbell, L., Southam, J., Chudyk, A., …Hill, J. C. (2024). The SelfSTarT intervention for low back pain patients presenting to first contact physiotherapists: A mixed methods service evaluation. Musculoskeletal Care, 22(1), Article e1876. https://doi.org/10.1002/msc.1876

• Journal Article Type: Article
• Acceptance Date: Mar 1, 2024
• Online Publication Date: Mar 21, 2024
• Publication Date: 2024-03
• Deposit Date: Mar 27, 2024
• Publicly Available Date: Mar 27, 2024
• Journal: Musculoskeletal Care
• Print ISSN: 1478-2189
• Electronic ISSN: 1557-0681
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1
• Article Number: e1876
• DOI: https://doi.org/10.1002/msc.1876
• Keywords: back care, self‐management, assistive technology
• Public URL: https://keele-repository.worktribe.com/output/784608