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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_10 | Pages 2 - 2
1 Oct 2019
Konstantinou K Lewis M Dunn K Hill J Artus M Foster N
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Background and Purpose. Healthcare for sciatica is usually ‘stepped’ with initial advice and analgesia, then physiotherapy, then more invasive interventions if symptoms continue. The SCOPiC trial tested a stratified care algorithm combining prognostic and clinical characteristics to allocate patients into one of three groups, with matched care pathways, and compared the effectiveness of stratified care (SC) with non-stratified, usual care (UC). Methods. Pragmatic two-parallel arm RCT with 476 adults recruited from 42 GP practices and randomised (1:1) to either SC or UC (238 per arm). In SC, participants in group 1 were offered up to 2 advice/treatment sessions with a physiotherapist, group 2 were offered up to 6 physiotherapy sessions, and group 3 was ‘fast-tracked’ to MRI and spinal specialist opinion. Primary outcome was time to first resolution of sciatica symptoms (6-point ordinal scale) collected via text messages. Secondary outcomes (4 and 12 months) included leg and back pain intensity, physical function, psychological status, time-off-work, satisfaction with care. Primary analysis was by intention to treat. Results. Primary outcome data were obtained from 89.3% (88.3% SC, 90.3% UC). Survival analysis showed a small but not statistically significant difference in time to resolution of symptoms (SC reached resolution 2 weeks earlier than UC; HR 1.14 (95% CI 0.89, 1.46)). There were no significant between-arm differences in secondary outcomes. Conclusion. The SC model, tested in this trial was not more effective than UC. On average, patients in both arms made similar good improvements over time, on most outcomes. No conflicts of interest. Funding: This report presents independent research commissioned by the National Institute for Health Research (NIHR) (NIHR HTA project number 12/201/09). NEF is a Senior NIHR Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). KK was supported by a HEFCE Senior Clinical Lectureship award. The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the Health Technology Assessment programme or the Department of Health


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_I | Pages 18 - 18
1 Jan 2012
Jensen R Leboeuf-Yde C
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Background. The outcome of studies on back pain is usually measured at specific intervals (1 month, 3 months, etc.) However, because LBP is a recurring condition it would be more relevant to identify outcome in relation to course over time. A new data collection tool was recently developed (SMS-Track), allowing this to be done. Aims. present the SMS-Track system. give some examples of how the course pattern varies between patients with back pain. Methods. Each week for a year 80 patients with LBP participating in an RCT responded to two automated SMS-questions relating to “days of pain” and “days of sick-leave” during the preceding week. Patients sent one text message in return for each question with an answer from “0” to “7” days. Replies were automatically stored in a data file that later was used for analysis. Examples of graphs will be given, to show how patterns can be viewed for each individual patient. Results and discussion. The frequent points of data collection made it possible to view each patient's specific reporting pattern. These patterns showed that some patients improve immediately, whereas others have various types of fluctuating patterns. The sick-leave pattern did not necessarily follow the pain pattern. Examples will be given in the poster. Conclusion. SMS-track was found to be a useful tool for obtaining repeated measurements at short intervals over long periods of time allowing detailed insight into various disease patterns. This appears particularly interesting in diseases of a recurring nature. In addition, this method has a very high response rate