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Delivery of low back pain management in Primary Care.

The overall aim of our research is to improve delivery of care for people with low back pain (LBP) in New Zealand (NZ). Our goal is to contribute to changes in a system that provides care according to need rather than the ability to pay, or capacity to successfully navigate the system.

Our research explores a range of management and treatment approaches by providing critical insight about preferences for LBP treatment, and solutions to difficulties with accessing primary care.

Current projects

A person experiencing lower back pain stock image thumbFeasibility and acceptability of a stratified model of acute low back pain management in primary care in New Zealand: a focus group study

This research aims to explore the perceptions of health professionals and people with experience of acute LBP about the acceptability and importance of psychosocial factors when making LBP treatment decisions. We will investigate participants perceptions about the feasibility of implementing a stratified care approach such as STarT Back in NZ (see below for more about STarT Back).

Seeking participants who are:

  • General Practitioners, physiotherapists, osteopaths and other healthcare providers, 

and who:

  • regularly treat people with acute low back pain (< 3months duration) in primary care settings.

What will you be asked to do:

  • take part in one focus group of 4-6 participants from the same profession, conducted via Zoom.
  • It will take between 90-120 mins and will be recorded for later analysis.
  • The focus group will include an educational presentation about best practice for the management of people with acute LBP; stratified care; describe psychosocial risk factors and their importance in LBP; and describe the STarT Back approach. We will then ask questions that address the study aims.

You will receive a $50 voucher in recognition of any costs of being a participant.

For further information about what you will be asked to do see the participant information sheet. 

Interested in the study? Contact:

Contact: Dr Cathy Chapple, School of Physiotherapy, University of Otago, Dunedin
phone: 0800 687 489 

Further information about STarT Back

Management of acute low back pain (LBP) can be challenging and costly for healthcare professionals that provide it and people who experience it. Stratified care is a possible solution that matches treatment to subgroups of patients according to presence of risk factors at initial presentation.

STarT Back is a stratified care approach based on identification of psychosocial risk factors for developing persistent symptoms or LBP associated disability. It was developed in the United Kingdom and has been shown to be clinically and cost effective. However, we do not know the acceptability or feasibility of implementing STarT Back in New Zealand.

This research project is funded by a Health Research Council of NZ Health Delivery Activation Grant, and this project has been reviewed and approved by the University of Otago Human Ethics Committee,
(Health). Reference: H21/126

Understanding, perceptions and attitudes of physiotherapists to the STarTBack Approach. 

Williams, D. R. (2021). STarTBack Approach in New Zealand: A qualitative examination of the understanding, perceptions, and attitudes of physiotherapists to the STarTBack Approach (Thesis, Master of Physiotherapy). University of Otago.

This study implemented the STarTBack screening tool into routine clinical practice and gathered physiotherapists views on the STarTBack Approach. Overall, several salient barriers and facilitators to implementation of the STarTBack Approach in New Zealand were identified. Physiotherapists agreed with the evidence behind the STarTBack Approach, did not foresee significant impacts to their normal clinical practice, and felt confident to deliver the matched treatment protocols. Concerns were noted with meeting patient expectations, managing changes to remuneration, and potential lack of funding agencies endorsement of the STarTBack Approach. Any future implementation studies need to address these barriers to facilitate successful uptake of the STarTBack Approach.  To read more