A pilot trial led by Keele University has shown promising results in assisting GPs to appropriately manage musculoskeletal (MSK) pain while reducing the use of painkillers and X-rays.
The trial looked at the impact of the Keele STarT MSK tool, which stratifies care (matching patients to specific treatments) for patients with MSK pain. The approach included a short 10-item questionnaire to classify individuals into one of the three groups (low, medium or high risk for persistent pain and disability), followed by matching the patient to a recommended treatment option.
GPs were given specific training to use new software in their existing computer systems to guide treatments for each group and were provided with monthly feedback comparing their decisions with colleagues.
The investigators recruited 524 adults with back, neck, knee, shoulder or multisite pain from eight GP practices within the West Midlands region and followed up on outcomes over six months.
The results showed that GPs matched patients to recommended treatment options well (>80% of cases). However, GPs completed the Keele STarT MSK tool in just 32 per cent of patient cases when the target was >50 per cent.
The new approach was associated with positive changes in the provision of high-quality written educational information for patients, more referrals to services like physiotherapy for patients at risk for poor outcomes, fewer prescriptions for strong painkillers known as opioids and fewer X-rays.
Following the success of the pilot trial, the team from Keele University has refined the new approach and is now carrying out a definitive trial with 1200 patients and 24 GP practices, with the results expected in summer 2020.