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Implementation of the Enhanced Transtheoretical Model Intervention (ETMI) for Low Back Pain patients in primary care: Study Protocol

Implementation of the Enhanced Transtheoretical Model Intervention (ETMI) for Low Back Pain patients in primary care: Study Protocol
Implementation of the Enhanced Transtheoretical Model Intervention (ETMI) for Low Back Pain patients in primary care: Study Protocol
Background: Self-management, an active life routine, and adherence to physical activity are effective in the management of low back pain (LBP). However, delivering effective education and reassurance to patients can be a difficult for practitioners. The enhanced transtheoretical model intervention (ETMI) has shown to be successful and cost effective. The intervention focuses on educating practitioners to reassure patients, empower them to increase physical activity, and improve their self-efficacy.
Objectives: To assess whether ETMI can be implemented among primary care practitioners and to examine whether it reduces pain, disability, and fear avoidance as well as decreasing healthcare utilization. This protocol outlines the methodology for the implementation of ETMI through a hybrid implementation-effectiveness design.
Methods: Two qualitative and mixed-method studies provided a basis for an implementation prospective cohort study. Discussions are followed by a prospective cohort study with pre-and post-intervention measures as well as descriptions retrieving economic and therapeutic outcome data from the Maccabi Healthcare Services (MHS) databases. In addition, a fourth qualitative study was conducted at the midpoint of the implementation to evaluate the process by measuring the perceptions and practice of practitioners. The intervention group was 220 primary care practitioners and their patients (~n=10,000) from the central district of MHS. The control data was provided by other care districts with similar socioeconomic makeup (~n=40,000).
Conclusions: We evaluated the process and outcomes of the implementation of ETMI. We investigated the relationship between the care received (ETMI against treatment as usual) and healthcare utilization, costs, and patient-clinical outcomes.
Exercise Therapy/methods, Humans, Low Back Pain/therapy, Primary Health Care, Prospective Studies, Transtheoretical Model
1565-1088
375-381
Feldman, Ron
369ffd5d-98eb-405a-88a9-42ead9d50408
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
Ben Ami, Noa
99af5f24-d185-4fd7-8059-fee3baf7690d
Feldman, Ron
369ffd5d-98eb-405a-88a9-42ead9d50408
Pincus, Tamar
55388347-5d71-4fc0-9fd2-66fbba080e0c
Ben Ami, Noa
99af5f24-d185-4fd7-8059-fee3baf7690d

Feldman, Ron, Pincus, Tamar and Ben Ami, Noa (2022) Implementation of the Enhanced Transtheoretical Model Intervention (ETMI) for Low Back Pain patients in primary care: Study Protocol. The Israel Medical Association journal : IMAJ, 24 (6), 375-381.

Record type: Article

Abstract

Background: Self-management, an active life routine, and adherence to physical activity are effective in the management of low back pain (LBP). However, delivering effective education and reassurance to patients can be a difficult for practitioners. The enhanced transtheoretical model intervention (ETMI) has shown to be successful and cost effective. The intervention focuses on educating practitioners to reassure patients, empower them to increase physical activity, and improve their self-efficacy.
Objectives: To assess whether ETMI can be implemented among primary care practitioners and to examine whether it reduces pain, disability, and fear avoidance as well as decreasing healthcare utilization. This protocol outlines the methodology for the implementation of ETMI through a hybrid implementation-effectiveness design.
Methods: Two qualitative and mixed-method studies provided a basis for an implementation prospective cohort study. Discussions are followed by a prospective cohort study with pre-and post-intervention measures as well as descriptions retrieving economic and therapeutic outcome data from the Maccabi Healthcare Services (MHS) databases. In addition, a fourth qualitative study was conducted at the midpoint of the implementation to evaluate the process by measuring the perceptions and practice of practitioners. The intervention group was 220 primary care practitioners and their patients (~n=10,000) from the central district of MHS. The control data was provided by other care districts with similar socioeconomic makeup (~n=40,000).
Conclusions: We evaluated the process and outcomes of the implementation of ETMI. We investigated the relationship between the care received (ETMI against treatment as usual) and healthcare utilization, costs, and patient-clinical outcomes.

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More information

Published date: June 2022
Keywords: Exercise Therapy/methods, Humans, Low Back Pain/therapy, Primary Health Care, Prospective Studies, Transtheoretical Model

Identifiers

Local EPrints ID: 475533
URI: http://eprints.soton.ac.uk/id/eprint/475533
ISSN: 1565-1088
PURE UUID: 0a2017e8-be75-4cb9-ab74-af93fa566abe
ORCID for Tamar Pincus: ORCID iD orcid.org/0000-0002-3172-5624

Catalogue record

Date deposited: 21 Mar 2023 17:38
Last modified: 17 Mar 2024 04:11

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Contributors

Author: Ron Feldman
Author: Tamar Pincus ORCID iD
Author: Noa Ben Ami

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