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
Primary care assessment: Core Tool
Assessment form to be completed by primary care during assessment
History: Brief pain inventory
Self administered questionnaire to assess the severity of pain and the impact of pain on daily functions
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
History: Canadian Association of Radiology guidelines
Referral guidelines that provide the criteria for diagnostic imaging
Screening: National Narcotic risk screening tool
Access to a range of tools that assess and screen for risk of addictions
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
Screening: Motivational interviewing
Tool for primary care that is a collaborative personed approach to interviewing to assist people in facilitating change
Neuropathic pain: DN4 tool
Four questions asked by primary care to determine if the pain is neuropathic
Inflammatory back pain: NASS
Self assessment of inflammatory back pain
Inflammatory back pain: Bath Ankylosing Spondilitis Disease Activity Index (BASDAI)
Self administered questionnaire that measures the disease activity of Ankylosing Spondylitis
Inflammatory back pain: Bath Ankylosing Spondylitis Functional Index
Self administered questionnaire that measure the functional abilities of patients with ankylosing spondilitis
Inflammatory back pain: OsteoporosisFRAX risk
Self administered questionnaire that identified osteoporosis risk
Depression screening: PHQ-9
Self administered questionnaire that identifies risk of depression
Functional limitation screening: Roland Morris
Self administered questionnaire that measures health status measure for low back pain
Functional limitation screening: Oswestry Disability Index
Self administered questionnaire that measures physical functioning
