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IMPARTS and Pain

IMPARTS and Pain

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IMPARTS and Pain

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Presentation Transcript

  1. IMPARTS and Pain Back to Me Programme Christina Sothinathan Clinical Lead Physiotherapist KCH

  2. IMPARTS • Pre-Assessment Screening for: • Depression • Anxiety • STarT Back (low, medium, high) • Psychosocial barriers to therapy • PROM EQ-5D – KPI

  3. % of patients screened

  4. % of those screened with positive PHQ-9 and GAD-7 scores 2017-2018

  5. STarT scores 2017-2018

  6. Previous service evaluation • No stratification of care of back pain patients based on STarT scores

  7. Previous Pathway: Stratification of care based on STarT scores History and examination: Assess severity, impact and persistent disability risk using STarT Back Tool Medical emergency – caudaequina Red Flag Discuss with GP or MCATs Refer immediately to A&E or discuss with neurosurgeon on-call Motor weakness Radicular pain +/- neurological deficit Refer to MCATS or back to GP High risk on STarT Low risk on STart Medium risk on STart 1:1 care or back class, Manual therapy, acupuncture exercise programme Persistent pain booklet & talk Await for biopyschosocialAx (future project) Advise, reassurance, back book SOS? DC? On going symptoms (radicular at 3 months) consider referral to MCATs or back to GP

  8. Use IMPARTS to inform stratification of care for pathway High risk on STarT Low risk on STart Medium risk on STart 1:1 care or Back on Track, Manual therapy, acupuncture exercise programme Persistent pain booklet biopyschosocial informed approach 1:1 care Back to Me Advise, reassurance, back book SOS? DC?

  9. Back to Me • Pain Education • Value Based Goal Setting • Mindfulness • Mindful movement • Tai Chi • Motivational interviewing • Coping with setbacks

  10. Thank you for listening