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  • Home
  • About
    • Message from the Chair
    • Steering Committee
    • Partnership Organizations
    • Global Burden of Disease Reports
    • Global Alliance for Musculoskeletal Health
    • Privacy/Security Policy
  • BJC Approach
  • Programs
    • Low Back Pain
      • Lower Back Pain and You
      • Health Care Professionals
      • BJC Low Back Pain Framework
      • National Framework for a Patient Centered LPB Model of Care
    • Osteoarthritis
      • Osteoarthritis and You
      • Health Care Professionals
        • GLA:D Canada
        • OA programs in Canada
        • When to get a consultation for hip or knee replacement surgery
    • Injury Prevention
      • Injury Prevention and You
      • Health Care Professionals
      • Communication Materials
      • Health Care Professionals
    • Hip Fracture
      • Hip Fracture and you
      • Health Care Professionals
      • Hip Fracture webinar
      • Trouse Nationale de Soins pour les Fractures de la Haunche
      • Supporting Research
      • Delirium, Dementia and Depression
      • Prevention
      • National Project
    • Hip & Knee Replacement Toolkit
      • Hip & Knee Replacement and You
      • Health Care Professionals
        • Hip and Knee Replacement Appropriateness
    • Young Investigator Initiative
      • Young Investigator Application Process
  • News & Events
    • BJC News
    • Event Calendar
    • Stories from Across Canada
  • Contact
    • Join our Mailing List

Evidence-Based Primary and Appropriate Specialist Assessment, Investigation and Management

All processes across a LBP Model of Care need to be evidence-based where available.

Stratified approach to initial patient assessment and management:

  • Medical and psychological stratification
    • Mechanical patterns
    • Screening for Red FLAGS
      • NIFTI: Neurological, Infection, Fracture, Tumor, Inflammatory
    • Yellow flags /Risk of chronicity
    • Narcotic risk assessment
  • Incorporation of Motivational Interviewing and Brief Action Planning by all health professionals
  • Use of electronic tools including electronic medical records
  • Referral criteria for appropriate investigations
  • Referral criteria for appropriate specialist referral

 

Tools

Primary care assessment: Core Tool
Assessment form to be completed by primary care during assessment
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History: Brief pain inventory
Self administered questionnaire to assess the severity of pain and the impact of pain on daily functions
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History: STarT Back
Self administered 9 item questionnaire that is a validated tool, designed to screen patients in primary care with low back pain for prognostic indicators that are relevatn to initial decision making
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History: Canadian Association of Radiology guidelines
Referral guidelines that provide the criteria for diagnostic imaging
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Screening: National Narcotic risk screening tool
Access to a range of tools that assess and screen for risk of addictions
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Screening: Brief action planning
Training materials on brief action planning to assist primary care in working with patients to develop plans for successful treatment strategies
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Screening: Motivational interviewing
Tool for primary care that is a collaborative personed approach to interviewing to assist people in facilitating change
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Neuropathic pain: DN4 tool
Four questions asked by primary care to determine if the pain is neuropathic
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Inflammatory back pain: NASS
Self assessment of inflammatory back pain
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Inflammatory back pain: Bath Ankylosing Spondilitis Disease Activity Index (BASDAI)
Self administered questionnaire that measures the disease activity of Ankylosing Spondylitis
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Inflammatory back pain: Bath Ankylosing Spondylitis Functional Index
Self administered questionnaire that measure the functional abilities of patients with ankylosing spondilitis
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Inflammatory back pain: OsteoporosisFRAX risk
Self administered questionnaire that identified osteoporosis risk
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Depression screening: PHQ-9
Self administered questionnaire that identifies risk of depression
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Functional limitation screening: Roland Morris
Self administered questionnaire that measures health status measure for low back pain
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Functional limitation screening: Oswestry Disability Index
Self administered questionnaire that measures physical functioning
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  • National Framework for a Patient Centered LPB Model of Care
  • Timely Access to Primary and Specialized LBP Care
  • Evidence-Based Primary and Appropriate Specialist Assessment, Investigation and Management
  • Inter-Professional Shared-Care Approach
  • Continuing Inter-Professional Development
  • Long-Term Self-Management Strategies, Chronicity Prevention and Health Promotion Strategies
  • Program Evaluation

About Bone and Joint Canada

Bone and Joint Canada (BJC) has developed partnerships across Canada with health care providers committed to the management of people presenting with musculoskeletal disorders. Working through clinical, administrative and policy leaders in each of the provinces BJC has developed a network approach to improving system performance and patient care. By working together and building on these relationships there are significant opportunities for improving the care for MSK patients across Canada through the next decade.
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