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Physiotherapists’ views of implementing a stratified treatment approach for patients with low back pain in Germany: a qualitative study

Overview of attention for article published in BMC Health Services Research, March 2018
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  • Above-average Attention Score compared to outputs of the same age (63rd percentile)
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Title
Physiotherapists’ views of implementing a stratified treatment approach for patients with low back pain in Germany: a qualitative study
Published in
BMC Health Services Research, March 2018
DOI 10.1186/s12913-018-2991-3
Pubmed ID
Authors

Sven Karstens, Pauline Kuithan, Stefanie Joos, Jonathan C. Hill, Michel Wensing, Jost Steinhäuser, Katja Krug, Joachim Szecsenyi

Abstract

The STarT-Back-Approach (STarT: Subgroups for Targeted Treatment) was developed in the UK and has demonstrated clinical and cost effectiveness. Based on the results of a brief questionnaire, patients with low back pain are stratified into three treatment groups. Since the organisation of physiotherapy differs between Germany and the UK, the aim of this study is to explore German physiotherapists' views and perceptions about implementing the STarT-Back-Approach. Three two-hour think-tank workshops with physiotherapists were conducted. Focus groups, using a semi-structured interview guideline, followed a presentation of the STarT-Back-Approach, with discussions audio recorded, transcribed and qualitatively analysed using content analysis. Nineteen physiotherapists participated (15 female, mean age 41.2 (SD 8.6) years). Three main themes emerged, each with multiple subthemes: 1) the intervention (15 subthemes), 2) the healthcare context (26 subthemes) and 3) individual characteristics (8 subthemes). Therapists' perceptions of the extent to which the STarT-Back intervention would require changes to their normal clinical practice varied considerably. They felt that within their current healthcare context, there were significant financial disincentives that would discourage German physiotherapists from providing the STarT-Back treatment pathways, such as the early discharge of low-risk patients with supported self-management materials. They also discussed the need for appropriate standardised graduate and post-graduate skills training for German physiotherapists to treat high-risk patients with a combined physical and psychological approach (e.g., communication skills). Whilst many German physiotherapists are positive about the STarT-Back-Approach, there are a number of substantial barriers to implementing the matched treatment pathways in Germany. These include financial disincentives within the healthcare system to early discharge of low-risk patients. Therapists also highlighted the need for solutions in respect of scalable physiotherapy training to gain skills in combined physical and psychological approaches.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 95 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 95 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 17 18%
Researcher 11 12%
Student > Ph. D. Student 11 12%
Student > Bachelor 10 11%
Other 9 9%
Other 13 14%
Unknown 24 25%
Readers by discipline Count As %
Nursing and Health Professions 27 28%
Medicine and Dentistry 15 16%
Sports and Recreations 5 5%
Unspecified 4 4%
Social Sciences 4 4%
Other 10 11%
Unknown 30 32%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 4. 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 12 September 2018.
All research outputs
#6,872,724
of 23,031,582 outputs
Outputs from BMC Health Services Research
#3,333
of 7,711 outputs
Outputs of similar age
#119,641
of 330,033 outputs
Outputs of similar age from BMC Health Services Research
#116
of 215 outputs
Altmetric has tracked 23,031,582 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 7,711 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.8. This one has gotten more attention than average, scoring higher than 56% of its peers.
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 330,033 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 63% of its contemporaries.
We're also able to compare this research output to 215 others from the same source and published within six weeks on either side of this one. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.