Determinants Of Patient Experience With Low Back Pain Interdisciplinary Care: A Pre-Post Interventional Study

Abstract

Amédé Gogovor,1,2 Regina Visca,3,4 Mark A Ware,4,5 Marie-France Valois,6 Gillian Bartlett,4 Matthew Hunt,7 Sara Ahmed2,4,71Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada; 2Centre for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada; 3RUIS McGill Centre of Expertise in Chronic Pain, Montreal, Quebec, Canada; 4Department of Family Medicine, McGill University, Montreal, Quebec, Canada; 5Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Quebec, Canada; 6Department of Medicine, McGill University, Montreal, Quebec, Canada; 7School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, CanadaCorrespondence: Sara AhmedSchool of Physical and Occupational Therapy, Faculty of Medicine, McGill University, 3654 Prom Sir-William-Osler, Montreal, QC H3G 1Y5, CanadaTel [phone] Ext 00531Fax [phone]Email [email protected] and purpose: Measuring patients’ experiences of health services has become an essential part of quality of care reporting and a means for identifying opportunities for improvement. This study aimed to evaluate change in patient experience in an interdisciplinary primary care program and to estimate the impact on patient experience of sociodemographic, function, pain and general health status, resource utilization, and process variables.Patients and methods: A 6-month interdisciplinary care program for individuals with low back pain (LBP) was implemented at four primary care settings and evaluated using an observational pre/post study design. The change in patient experience was evaluated using the Patient Assessment of Chronic Illness Care questionnaire (PACIC) completed at baseline and 6 months post-intervention (n=132). Descriptive and multivariable analyses were performed using SAS version 9.3.Results: The average patient age was 57 (SD: 14) years of age and the majority were female (53%). The mean overall PACIC score was 2.6 (SD: 1.1) at baseline and 3.6 (SD: 0.9) at 6 months. The experience of care improved for 62% of the participants based on the minimal clinically important difference (MCID). No significant determinants of overall PACIC change score were identified in the multivariable regression models.Conclusion: The lack of association of hypothesized determinants requires further examination of the properties of the PACIC and with a larger sample. Future investigation is needed on the relationship between improved patient experience and outcomes.Keywords: patient care team, low back pain, patient experience, PACIC, primary health care

Keywords

• patient care team
• low back pain
• patient experience
• pacic
• primary health care.