Grant: Project Grant

Low back pain (LBP) is a leading cause of disability, is one of the most common reasons for visiting a family doctor, and costs the Canadian health care system between $6 and $12 billion a year. A growing population that is increasing in age and experiencing more chronic health concerns is making it difficult for family doctors to meet the multiple needs of patients. One way to support doctors is to build a team of healthcare providers to help address the needs of patients. Physiotherapists provide evidence-based management for LBP. If physiotherapists are integrated within primary care teams and people with LBP are able to see the physiotherapist at their first visit for LBP, they may get a more focused LBP assessment and experience improved outcomes. This new model of care also has the potential to reduce workload on family doctors and reduce unnecessary diagnostic imaging and specialist referrals that are common in LBP. The proposed study will determine the effectiveness of integrating physiotherapists within family doctor's offices for patients with LBP. It will evaluate the effectiveness of this new approach on patient health outcomes (function, pain, quality of life, perceived change, and side effects of treatment) as well as health system and societal outcomes (access to healthcare, healthcare use, physician workload, missed work, and cost effectiveness). The study will involve randomly assigning 20 doctor's offices to either integrate a physiotherapist within the team for people with LBP or to continue with usual care led by the doctor. Participants will be assessed six times over a one-year period to compare the results between sites with a physiotherapist and sites without a physiotherapist. The results of this study have the potential to transform healthcare for LBP by informing decision makers about whether physiotherapists should be integrated within family doctors' offices more widely.