Development of a return to work tool for primary care providers for patients with low back pain: a pilot study.

Details

• Personal Author:
  Cruz L ; Nabeel I ; Sheth P
• Description:
  Purpose: Low back pain (LBP) is a common cause of disability and is primarily seen and treated first by primary care physicians (PCPs). Rapid return to normal activities, including work, is generally the best recommendation as proposed by the American College of Physicians. Despite these guidelines, PCPs often feel ill prepared to make such recommendations. The purpose of our project was to develop return to work (RTW) guidelines in the form of an accessible Electronic Medical Records (EMR) integrated tool. Methods: Licensed PCPs who see patients > 18 year old, presenting with acute LBP who are currently employed were eligible for participation. RTW Guidelines were developed and integrated into the EMR. PCPs were randomized with and without the RTW guidelines. Using ICD 10 codes to identify patients with LBP, charts were data-mined to assess if PCPs made recommendations regarding RTW. Results: 84 study participants were enrolled in the study. 45 were randomized into the intervention group and 39 into the control group. In the intervention group, 301 patient encounters met the inclusion criteria for acute LBP. Of these, the tool offering RTW recommendations was used in 9.3% of those encounters (n=28). Comparatively, 256 patient encounters met the inclusion criteria in the control group. Of these, the control group offered RTW recommendations in 1.9% of those encounters (n=5). This was a statistically significant difference (p < 0.01). Conclusion: This study showed that PCPs frequently encounter patients with LBP, yet they rarely offer RTW or activity recommendations, however, those with access to the RTW guidelines were significantly more likely to make such recommendations to their patients. Recommending RTW and resuming normal activities is critical in preventing long term pain and disability associated with LBP. As such, developing tools to translate practice guidelines into clinical practice is mandatory to accomplish this goal. [Description provided by NIOSH]
• Subjects:
  Explosions Mining Occupational Health Safety
• Keywords:
  Author Keywords: Workforce; Physical Activity Musculoskeletal Disorders; MSD; Low Back Pain; Return To Work; Medical Examinations; Electronic Health Records; Medical Records; Intervention;
• Publisher:
  American Public Health Association
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• NIOSHTIC Number:
  nn:20065839
• Citation:
  Creating the Healthiest Nation: Health Equity Now. APHA 146th Annual Meeting and Exposition, November 10-14, 2018, San Diego, California. Washington, DC: American Public Health Association, 2018 Nov; :415977
• Federal Fiscal Year:
  2019
• Performing Organization:
  Mount Sinai School of Medicine
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Creating the Healthiest Nation: Health Equity Now. APHA 146th Annual Meeting and Exposition, November 10-14, 2018, San Diego, California
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9202224e615772d59e639a88de1dd62712485cdc7a6115e89df60e6eba07e0cc707d7fbfbd58223810bd165afd74a29442638d723e485779c5b928708153d17a
• Download URL:
  https://stacks.cdc.gov/view/cdc/248856/cdc_248856_DS1.pdf
• File Type:
  [PDF - 56.55 KB ]