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Implementing the Keele stratified care model for patients with low back pain: an observational impact study

Overview of attention for article published in BMC Musculoskeletal Disorders, February 2017
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1 tweeter

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Title
Implementing the Keele stratified care model for patients with low back pain: an observational impact study
Published in
BMC Musculoskeletal Disorders, February 2017
DOI 10.1186/s12891-017-1412-9
Pubmed ID
Authors

Adrian Bamford, Andy Nation, Susie Durrell, Lazaros Andronis, Ellen Rule, Hugh McLeod

Abstract

The Keele stratified care model for management of low back pain comprises use of the prognostic STarT Back Screening Tool to allocate patients into one of three risk-defined categories leading to associated risk-specific treatment pathways, such that high-risk patients receive enhanced treatment and more sessions than medium- and low-risk patients. The Keele model is associated with economic benefits and is being widely implemented. The objective was to assess the use of the stratified model following its introduction in an acute hospital physiotherapy department setting in Gloucestershire, England. Physiotherapists recorded data on 201 patients treated using the Keele model in two audits in 2013 and 2014. To assess whether implementation of the stratified model was associated with the anticipated range of treatment sessions, regression analysis of the audit data was used to determine whether high- or medium-risk patients received significantly more treatment sessions than low-risk patients. The analysis controlled for patient characteristics, year, physiotherapists' seniority and physiotherapist. To assess the physiotherapists' views on the usefulness of the stratified model, audit data on this were analysed using framework methods. To assess the potential economic consequences of introducing the stratified care model in Gloucestershire, published economic evaluation findings on back-related National Health Service (NHS) costs, quality-adjusted life years (QALYs) and societal productivity losses were applied to audit data on the proportion of patients by risk classification and estimates of local incidence. When the Keele model was implemented, patients received significantly more treatment sessions as the risk-rating increased, in line with the anticipated impact of targeted treatment pathways. Physiotherapists were largely positive about using the model. The potential annual impact of rolling out the model across Gloucestershire is a gain in approximately 30 QALYs, a reduction in productivity losses valued at £1.4 million and almost no change to NHS costs. The Keele model was implemented and risk-specific treatment pathways successfully used for patients presenting with low back pain. Applying published economic evidence to the Gloucestershire locality suggests that substantial health and productivity outcomes would be associated with rollout of the Keele model while being cost-neutral for the NHS.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 74 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 74 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 27%
Other 7 9%
Researcher 7 9%
Student > Ph. D. Student 7 9%
Student > Doctoral Student 4 5%
Other 13 18%
Unknown 16 22%
Readers by discipline Count As %
Medicine and Dentistry 19 26%
Nursing and Health Professions 15 20%
Sports and Recreations 5 7%
Business, Management and Accounting 2 3%
Neuroscience 2 3%
Other 9 12%
Unknown 22 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 February 2017.
All research outputs
#4,911,869
of 9,046,056 outputs
Outputs from BMC Musculoskeletal Disorders
#1,351
of 2,225 outputs
Outputs of similar age
#176,625
of 312,211 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#34
of 52 outputs
Altmetric has tracked 9,046,056 research outputs across all sources so far. This one is in the 27th percentile – i.e., 27% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,225 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.4. This one is in the 29th percentile – i.e., 29% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 312,211 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 52 others from the same source and published within six weeks on either side of this one. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.