Low back pain (LBP) is now recognised as an ongoing condition that for many is likely to shift and change over their lifetime.

Many of those treated for LBP in primary care will have low to moderate-intensity pain that fluctuates and continues for the long term.

Some will have episodic pain and some will have severe, persistent pain.

Many adults with LBP who experience worsening symptoms, such as increased or incomplete resolution of their pain, will seek further healthcare within 12 months after discharge from conservative management. 

In the Western Sydney Local Health District of Sydney alone, the rate of re-presentation to the hospital for further treatment for LBP after discharge from physiotherapy services represents a financial burden of $744,000 in direct annual healthcare costs.

Physiotherapists believe this re-presentation for further treatment may be driven by a lack of post-discharge care as well as low patient self-efficacy to follow advice given for managing symptoms at home.

The integration of a simple, low-cost, post-discharge support service into the care pathway of chronic LBP might help to reduce the burden and improve outcomes for those with ongoing LBP.

Lifestyle interventions such as health coaching, including telephone-based health coaching, can improve physical activity levels in patients with chronic LBP.

The Get Healthy Service, funded and managed by the New South Wales Ministry of Health, delivers a variety of such telephone-based health coaching programs.

A team of researchers from the University of Sydney—along with collaborators from physiotherapy outpatient departments in New South Wales hospitals and from universities and research institutes—has developed a research project to assess the effectiveness and cost-effectiveness of a discharge support system.

The Get Back to Healthy project compares a discharge support system group to a usual care control group in people recently discharged from hospital outpatient physiotherapy treatment and/or from public or private physiotherapy, chiropractic or GP care for chronic LBP.

Incorporating referral to the Get Healthy Service, the discharge support system is designed to improve pain, disability and physical activity levels by assisting people to follow advice given by their treating healthcare practitioner.

In addition to determining the effectiveness and cost-effectiveness of the discharge support system, the research project investigates the future use of hospital, medical and health services for LBP.

Other secondary outcomes include the identification of factors related to the intervention, context, individual and implementation process.

Significance

If the study is successful, the project will provide robust evidence for the clinical effectiveness of using a discharge support service, and the study findings will help to inform healthcare policy and clinical practice for chronic LBP in Australia.

Who can participate

The research team is currently looking for participants residing in New South Wales who:

• are 18 years of age or older
• present with a diagnosis of non-specific LBP of at least 12 weeks duration, with or without leg pain but without radicular (eg, reflex changes, motor loss) symptoms. Non-specific LBP will be diagnosed after screening for serious spinal pathology and indicators of potentially serious conditions using ‘red’ flags
• have been recently discharged (less than four weeks post-treatment) from treatment from the outpatient physiotherapy departments of participating hospital sites or have been recently discharged (less than six months post-regular treatment) from a course of treatment by their physiotherapist, chiropractor or GP in either private or public practices (including hospitals). Discharge from a course of treatment describes people who are no longer receiving weekly treatment for their LBP
• have adequate hearing and eyesight to participate safely in physical activity
• have independent ambulatory status, with or without gait aid.

The research team, led by Professor Paulo Ferreira, will organise a time to discuss the study with potential participants, ensure their eligibility and enrol them.

The team also welcomes support from physiotherapists, GPs and chiropractic private clinics in New South Wales in referring potential participants to volunteer in the research study.

The study is conducted online and is free of cost.

How to get involved

If you are interested in assisting with this important and exciting area of research, contact the Get Back to Healthy central study team via email at getbacktohealthy.study@sydney.edu.au, click here or call 02 9114 4808.

Now underway, The Get Back to Healthy trial has ethics approval granted by the Western Sydney Local Health District Human Research Ethics Committee (2020/ETH00115) and has been prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000889954).

The trial is funded by Western Sydney Local Health District, as part of an Allied Health Kickstarter Research Grant, and a National Health and Medical Research Council Partnership Grant.

The Get Back to Healthy Study central study team is based at The University of Sydney, Faculty of Medicine and Health; and is part of the Charles Perkins Centre Musculoskeletal Research Hub.

The operational team comprises Emma Ho, Julian Comis, Katherine Roberts and Carlos Mesa, and is led by Professor Paulo Ferreira.