Productive Partnerships

University of Sydney

CONNECT: Telecare collaborative management of low back pain in primary care

Low back pain is rapidly becoming a common problem for adults. It can range from a dull constant ache to debilitating pain. The majority of low back pain is mechanical in nature and is commonly associated with the general degeneration of the spine that occurs with aging. It can range from a short-term problem to a persistent condition.

Most low back pain is defined as acute and will resolve on its own with self-care, leaving no lasting consequences. If the pain persists beyond 4 to 12 weeks, it is defined as subacute. Pain that persists for 12 weeks or longer is defined as chronic back pain and can be resolved with conservative treatment or surgery. Surgery for these conditions is among the fastest growing groups of surgical procedures across the world. Despite this, these procedures are often ineffective offering no long term benefit. In many cases patients progress to surgery without ever receiving the recommended elements of primary care management for these conditions.

In Australia, most of the 550,000 surgical procedures performed for musculoskeletal conditions every year are conducted to manage low back pain. As a result, low back pain costs Australia over $1.2 billion every year and over half of that expenditure arises from surgical management.

Despite being one of the most prevalent, costly and disabling medical disorders in Australia, few clinical trials have examined the value of healthy lifestyle interventions to improve chronic pain in primary care. To address these concerns, Medibank is partnering with The University of Sydney to develop and evaluate a new telecare model for patients with low back pain at the primary care level. Led by chief investigator Associate Professor Manuela L. Ferreira, the goal of this partnership is to improve disease management by coordinating patient access to appropriate GP care and community services. By helping the patient better control their disease, this proposed model will ultimately reduce rates of surgery.

The proposed model of care uses automated symptom and function monitoring, a health coach and management algorithm to optimise the primary care management of patients. The innovative approach aims to shift less technical tasks such as symptom monitoring from overburdened GPs either to be automated or delegated to care workers.

As low back pain is one of the most costly conditions to manage in Australia, this research program will provide crucial work towards improving the management of low back pain in primary care.