Development of a screening tool predicting the transition from acute to chronic low back pain for patients in a GP setting: protocol of a multinational prospective cohort study.
BACKGROUND
Low back pain (LBP) is by far the most prevalent and costly musculoskeletal problem in our society today. Following the recommendations of the Multinational Musculoskeletal Inception Cohort Study (MMICS) Statement, our study aims to define outcome assessment tools for patients with acute LBP and the time point at which chronic LBP becomes manifest and to identify patient characteristics which increase the risk of chronicity.


METHODS
Patients with acute LBP will be recruited from clinics of general practitioners (GPs) in New Zealand (NZ) and Switzerland (CH). They will be assessed by postal survey at baseline and at 3, 6, 12 weeks and 6 months follow-up. Primary outcome will be disability as measured by the Oswestry Disability Index (ODI); key secondary endpoints will be general health as measured by the acute SF-12 and pain as measured on the Visual Analogue Scale (VAS). A subgroup analysis of different assessment instruments and baseline characteristics will be performed using multiple linear regression models. This study aims to examine: 1. Which biomedical, psychological, social, and occupational outcome assessment tools are identifiers for the transition from acute to chronic LBP and at which time point this transition becomes manifest. 2. Which psychosocial and occupational baseline characteristics like work status and period of work absenteeism influence the course from acute to chronic LBP. 3. Differences in outcome assessment tools and baseline characteristics of patients in NZ compared with CH.


CONCLUSIONS
This study will develop a screening tool for patients with acute LBP to be used in GP clinics to access the risk of developing chronic LBP. In addition, biomedical, psychological, social, and occupational patient characteristics which influence the course from acute to chronic LBP will be identified. Furthermore, an appropriate time point for follow-ups will be given to detect this transition. The generalizability of our findings will be enhanced by the international perspective of this study.


BACKGROUND
[Clinical Trial Registration Number, ACTRN12608000520336].
Melloh
Markus
M
Department of Work and Organizational Psychology, Institute for Psychology, University of Berne, Muesmattstrasse 45, 3000 Berne 9, Switzerland. markus.melloh@otago.ac.nz
Aebli
Nikolaus
N
Elfering
Achim
A
Röder
Christoph
C
Zweig
Thomas
T
Barz
Thomas
T
Herbison
Peter
P
Hendrick
Paul
P
Bajracharya
Suraj
S
Stout
Kirsten
K
Theis
Jean-Claude
JC
D000041:Absenteeism; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D004651:Employment; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000639:trends; D008875:Middle Aged; D009520:New Zealand; D009784:Occupational Diseases / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000639:trends; D011446:Prospective Studies; D011584:Psychology; D018570:Risk Assessment / Q000379:methods / Q000639:trends; D013557:Switzerland; D055815:Young Adult