Improving The Routine Care Of Patients With Back Pain: The Role Of Public Involvement In Taking Successful Research Into Clinical Practice

Background Back pain can have a major impact on someone9s quality of life and ability to return to work. However, getting the right treatment to the right patients at the right time is difficult. Recent research 1 showed the effectiveness of a new way of allocating matched treatment to different patient groups based on their risk of poor outcomes (the “STarTBack” approach). It reduces disability, time off work and healthcare costs. STarTBack is recognised internationally as improving the care pathway for back pain patients but the challenge is taking it forward into routine clinical practice. Objectives To describe public involvement (PI) in taking the successful STarTBack research into routine clinical practice. Methods Providing clear and useful patient information was a key feature of the successful rollout of STarTBack. A PI group helped develop: 1) an information sheet on living with back pain given to patients during a GP consultation; 2) public pages of a STarTBack website; 3) a “Making Every Contact Count” manual to help health professionals have a conversation with patients about their back pain; and 4) a questionnaire to collect the patient experience of STarTBack. The project team met with the PI group on three occasions and provided regular feedback about their contribution. Results Six patients with back pain (three males, three females) formed the PI group. 1) Back pain information sheet: PI members highlighted the best aspects of two leaflets on back pain 2,3 (e.g. simple advice, useful images, clear layout), and suggested how existing information used in local GP practices for patients about living with back pain (provided by the patient.co.uk) could be adapted to include these. 2) STarTBack Website: PI members suggested content for the public pages of the STarTBack website that patients with back pain would find useful (www.keele.ac.uk/sbst/patients). 3) ‘Making Every Contact Count’ manual: PI members advised on the clarity, appropriateness and phrasing of key messages and example discussion prompts recommended for use by health professionals during conversations with patients with back pain. 4) Patient experience questionnaire: PI members thought existing NICE quality standard statements for patient experience of health services 4 were too long for use in a patient questionnaire. Members therefore suggested new items for a brief questionnaire based on their own back pain experiences. Conclusions Public involvement has provided a valuable contribution to the roll out of a successful research study into routine clinical practice to improve the treatment of patients with back pain. The PI group has improved the content and clarity of materials used to provide patient information, aid conversations between health professionals and patients with back pain, and collect the patient experience of STarTBack. The uptake and use of the STarTBack approach in local GP practices will be audited and evaluated during 2015-16. References Hill et al, Lancet,2011;378(9802):1560-1571 www.arthritisresearchuk.org/arthritisinformation/conditions/backpain www.patient.co.uk/pdf/4202.pdf www.nice.org.uk/guidance/qs15 Acknowledgements Supported by West Midlands Academic Health Science Network and NIHR Collaborations for Leadership in Applied Health Research and Care West Midlands. KS is funded by a NIHR Knowledge Mobilisation grant (KS, KMF-2012-01-35). Disclosure of Interest None declared