Grant: Fellowship - Priority Announcement: Knowledge Translation

Back pain is the second leading reason for family physician visits in Canada and people with back pain use significantly more health care resources each year than those without back pain.People with a variety of low back problems make up a large proportion of referrals made to orthopedic surgeons and many of these patients are not considered to be surgical candidates or have not fully explored non-surgical treatment options.This can contribute significantly to wait times for patients to consult with a surgeon and ultimately lead to greater wait times for other types of orthopedic surgeries.To date,very little research has explored alternative models of health care to help manage this problem. An assessment service performed by physiotherapists with advanced orthopedic training for people with low back problems referred to one of three orthopedic surgeons has been operating at a Saskatoon based rehabilitation clinic since 2003.However,the impact of this process on patient relevant outcomes and on patient and referring practitioner satisfaction is unknown.The purposes of this study are to determine:1)the impact of a physiotherapy triage assessment on patient self-reported function and quality of life and patient and referring practitioner satisfaction,2) which factors predict improved self-reported function,quality of life and patient and referring practitioner satisfaction and,3)how consistent physiotherapists and orthopedic surgeons are at diagnosing low back related problems.In addition, how patient characteristics such as age, gender, income, access to health care, and the presence of other health problems affect outcomes will be considered.The results of this study will assist Canadian health care providers, health care managers and policy makers to determine which patients benefit most from undergoing this type of assessment and will lead to more efficient management of people with low back related problems.