International comparative study of low back pain care pathways and analysis of key interventions

Ellen Coeckelberghs, Hilde Verbeke, Anja Desomer, Pascale Jonckheer, Daryl Fourney, Paul Willems, Maarten Coppes, Raja Rampersaud, Miranda van Hooff, Els van den Eede, Gerit Kulik, Pierre de Goumoens, Kris Vanhaecht, Bart Depreitere*

*Corresponding author voor dit werk

    OnderzoeksoutputAcademicpeer review

    8 Citaten (Scopus)
    241 Downloads (Pure)


    Purpose Low back pain (LBP) is a major public health problem worldwide. Significant practice variation exists despite guidelines, including strong interventionist focus by some practitioners. Translation of guidelines into pathways as integrated treatment plans is a next step to improve implementation. The goal of the present study was to analyze international examples of LBP pathways in order to identify key interventions as building elements for care pathway for LBP and radicular pain.

    Methods International examples of LBP pathways were searched in literature and grey literature. Authors of pathways were invited to fill a questionnaire and to participate in an in-depth telephone interview. Pathways were quantitatively and qualitatively analyzed, to enable the identification of key interventions to serve as pathway building elements.

    Results Eleven international LBP care pathways were identified. Regional pathways were strongly organized and included significant training efforts for primary care providers and an intermediate level of caregivers in between general practitioners and hospital specialists. Hospital pathways had a focus on multidisciplinary collaboration and stepwise approach trajectories. Key elements common to all pathways included the consecutive screening for red flags, radicular pain and psychosocial risk factors, the emphasis on patient empowerment and self-management, the development of evidence-based consultable protocols, the focus on a multidisciplinary work mode and the monitoring of patient-reported outcome measures.

    Conclusion Essential building elements for the construction of LBP care pathways were identified from a transversal analysis of key interventions in a study of 11 international examples of LBP pathways.

    Originele taal-2English
    Pagina's (van-tot)1043-1052
    Aantal pagina's10
    TijdschriftEuropean Spine Journal
    Nummer van het tijdschrift4
    Vroegere onlinedatum11-jan.-2021
    StatusPublished - apr.-2021


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