Study of the Effectiveness of General Practice Clinical Pathway for Medically Unexplained Disease Manifested by Low Back Pain

Abstract

Background Low back pain is a common cause of consultation for patients in primary care, however, there is a lack of unified diagnostic and treatment guidelines for the management of patients with low back pain in China. This paper initially establishes a general practice clinical pathway based on patients with low back pain through the preliminary research, and verifies its effectiveness through the adjustment of the management program. Objective To explore the clinical outcomes of general practice clinical pathway for medically unexplained diseases manifested by low back pain. Methods A total of 80 patients with low back pain attending the general practice outpatient clinic of Mishixiang Health Service Center in Gongshu District, Hangzhou City were selected as the study subjects and randomly divided into the control group and experimental group, with 40 cases in each group, by single and double visiting numbers. The experimental group was managed by the general practice clinical pathway for low back pain, and the control group was managed routinely. After six months of intervention, the Roland-Morris dysfunction score, Visual Analogue Pain Scale (VAS) score before and after intervention, and satisfaction of patients were compared between the two groups. Results There was no statistically significant difference in Roland-Morris dysfunction score and VAS pain score between the two groups before the intervention (P>0.05) ; Roland-Morris dysfunction score and VAS score of the experimental group were lower than those of the control group after the intervention (P<0.05) . The difference in Roland-Morris dysfunction score difference and VAS score difference before and after intervention between the two groups were statistically significant (P<0.05) . The satisfaction score of the experimental group was higher than that of the control group (P<0.05) . Conclusion The management of general practice clinical pathway for low back pain can effectively improve the functional situation of low back pain and enhance patient satisfaction, and provide research ideas for the management of other medically unexplained diseases.

Keywords

• low back pain|medically unexplained physical symptoms|critical pathways|general practice|validation study