IMPARTS and Pain Back to Me Programme Christina Sothinathan Clinical Lead Physiotherapist KCH
IMPARTS • Pre-Assessment Screening for: • Depression • Anxiety • STarT Back (low, medium, high) • Psychosocial barriers to therapy • PROM EQ-5D – KPI
Previous service evaluation • No stratification of care of back pain patients based on STarT scores
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
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?
Back to Me • Pain Education • Value Based Goal Setting • Mindfulness • Mindful movement • Tai Chi • Motivational interviewing • Coping with setbacks