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| Name | Class |
|---|---|
| Maccabi Healthcare Services, Israel | OTHER |
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The aim of this study is to assess whether the ETMI method can be implemented among primary care practitioners in the central district of Maccabi Health Services and examine whether it provides a medical and economic advantage.
An implementation study- a prospective cohort study with pre- and post-intervention by retrieving economic and therapeutic outcome data from MHS databases. The intervention group will be the Central District of MHS, among 220 primary care practitioners (100 Physicians and 120 physiotherapists) and their patients (n=7,000) who suffer from back pain and receive treatment. We will investigate the relationship between the care received and outcomes in terms of healthcare utilization, costs, and patient-relevant outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Central District | The ETMI method will be implemented in this group |
| |
| North District | control | ||
| Hasharon District | control | ||
| South District | control | ||
| Jerusalem and Hasfhela District | control |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| the Enhanced Transtheoretical Model Intervention (ETMI) | Other | ETMI consists of a physical and functional examination, a discussion about the role of physical activity matched to the patient stage of change, and guided through motivational interviewing techniques, exposure to fast walking, and goal setting. The patient receives a postcard outlining the main messages about physical activity and four simple stretches. The ETMI method consists of four parts:
|
| Measure | Description | Time Frame |
|---|---|---|
| ETMI Code | baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Lumbar Computerized Adaptive Test (LCAT) | LCAT is a computerized adaptive test, meaning that the administration selects items from the item bank one at a time based on an administrative algorithm. The final calculated functional score ranges on a linear scale of 0-100, higher measures representing higher function. Additionally, the system predicts a risk-adjusted functional score at discharge. The adjusting is on: functional score at admission, age, sex, chronicity as number of days from onset of the treated condition, number of related surgeries, exercise history and use of medication to treat LBP.MCID for the LCAT is 3-9 points depending on the first score. LCAT has been tested for validity by comparing it to the Oswestry Low Back Pain Disability Questionnaire and has a high level of reliability in the English version (α = 0.92).Several studies have been published using the LCAT's Hebrew version. |
| Measure | Description | Time Frame |
|---|---|---|
| Economic variables and therapeutic results | Number of primary care clinician appointments | baseline |
| Numeric Pain Rate Scale (NPRS) | The patient is asked to rate his pain intensity in the last 24 hours on a scale of 0-10 (10=severest pain) |
Inclusion Criteria:
Exclusion Criteria:
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220 primary care practitioners (100 Physicians and 120 physiotherapists) and their patients (n=7,000) who suffer from back pain and receive treatment.
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| Name | Affiliation | Role |
|---|---|---|
| Ron Feldman, PhD Candidate | Ariel University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ariel University | Ariel | 40700 | Israel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28142364 | Background | Ben-Ami N, Chodick G, Mirovsky Y, Pincus T, Shapiro Y. Increasing Recreational Physical Activity in Patients With Chronic Low Back Pain: A Pragmatic Controlled Clinical Trial. J Orthop Sports Phys Ther. 2017 Feb;47(2):57-66. doi: 10.2519/jospt.2017.7057. | |
| 29643158 | Background | Canaway A, Pincus T, Underwood M, Shapiro Y, Chodick G, Ben-Ami N. Is an enhanced behaviour change intervention cost-effective compared with physiotherapy for patients with chronic low back pain? Results from a multicentre trial in Israel. BMJ Open. 2018 Apr 10;8(4):e019928. doi: 10.1136/bmjopen-2017-019928. |
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the result of the study will be analyzed. a paper will be submitted to an international journal with study description including methods, examination protocol results.
one year following completion of study
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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|
| baseline |
| baseline |
| Fear Avoidance Belief Questionnaire (FABQ) | It is a modification to the original version, allowing for the assessment using an Item Response Theory-based measures replacing the summative methods. The later version consists of three items, scoring 0-100, with 100 representing higher fear-avoidance, and 44 being a cut-off point between high and low values | baseline |
| Economic variables and therapeutic results | Number of orthopedic clinician appointments | baseline |
| Economic variables and therapeutic results | Number of physiotherapy appointments | baseline |
| Economic variables and therapeutic results | Anti-inflammatory drug dosage | baseline |
| Economic variables and therapeutic results | Number of imaging tests | baseline |
| Economic variables and therapeutic results | Number of surgeries and procedures | baseline |
| 29712542 | Background | Simoneau GG. 2017 JOSPT Award Recipients. J Orthop Sports Phys Ther. 2018 May;48(5):348. doi: 10.2519/jospt.2018.0104. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |