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THE ACCESS TRIAL: RANDOMISED CONTROLLED TRIAL OF PUBLIC HOSPITALBASED VERSUS PRIVATE COMMUNITYBASED PHYSIOTHERAPY FOR PATIENTS WITH LOW BACK PAIN: THREE MONTH FOLLOW UP RESULTS



Abstract

Background: This pragmatic randomised controlled trial aimed to investigate any differences in the clinical outcomes of patients with low back pain (LBP) receiving physiotherapy in (i) the current public hospital-based secondary healthcare model (H) versus (ii) a private community-based primary healthcare model (P)

Participants & Methods: Between March 2005 and May 2006, 160 consenting subjects [110F, 50M; mean age (SD) yrs: 41.28 (12.83}], referred by GPs for physiotherapy for non-specific LBP were recruited across three clinical centres within Ireland Subjects completed a baseline interview and outcome measures (Roland Morris Disability Questionnaire (RMDQ), SF-36 V2 Pain Subscale, Fear Avoidance Beliefs Questionnaire, Back Beliefs Questionnaire), were stratified (acute: < 3/12; chronic: > 3/12), and randomised to one of the two groups (i.e. H: n=80; P: n=80), with follow ups at 3, 6 and 12 months post randomisation.

Analysis: Data were coded and questionnaires scored, then analysed using the Statistical Package for the Social Sciences (SPSS, Version 11). An intention-to-treat analysis was conducted. Patient follow-ups are ongoing: 3-month [completed by 31stth August 2006; current response rate: 82% (n =117/143)].

Results: Both groups were comparable for all baseline demographic variables and questionnaire scores. Current descriptive analysis of mean change scores (SD), from baseline to 3-months, show clinically meaningful improvements in both groups RMDQ: [H=3.95(−1.172); P=4.94(−0.816)] and SF-36 Bodily pain: [H=−7.51(=3.6); P= −10.54(−2.6)]. The complete 3-month data set will be presented at the meeting.

Conclusion & Implications: The findings may influence future health policy regarding the funding of physiotherapy services in Ireland.

Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.