SPLIT Project
SPLIT Project Presentation
The SPLIT Project aims to improve the quality of practice and the cost-effectiveness of the delivery of care in patients struggling with low back pain, through the implementation of an innovative stratified treatment of General Practice referral to Physiotherapy in primary health care.
The SPLIT Project is developed by a research group, including clinics and researchers of Superior Health School of Polytechnic - Institute of Setúbal and from NOVA Medical School of NOVA University of Lisbon with the partnership the Health Regional Administration of Lisbon and Tagus Valley through the Primary Care Center of Arrábida, co-funded by the Regional Operational Program of Lisbon, in the FEDER component and for the Foundation for Science and Technology, in a national level – OE.
Low back pain is the most prevalent musculoskeletal and rheumatic condition in Portugal. The self-reported prevalence of 26,4% is associated with prolonged and recurrent disability, low level of quality of life, anxiety and presence of depressive symptoms, and high costs related with work absenteeism, loss of productivity, early retirement, overuse of resources in health care. Therefore, low back pain is an urgent and global problem of public health.
Physiotherapy is the first-line intervention recommended by the clinical guidelines. The condition has good prognosis and most of the people recover in a 12 weeks period. However, about 10 to 15% of the people still reporting persistent pain after a year and develop an incapacitating condition. In this way, the use of a differentiated intervention taking account the early identification of the patient group with good prognosis and in risk of developing persistent and disabling pain is crucial to improve the health results and reduce the unappropriated and costly health care.
In Portugal, either at the level of referral for treatment or at the level of intervention in Physiotherapy, the risk profile of the patient in not taken into consideration. There is no referencing system capable of differentiate patients with low, medium and high level of risk of developing persistent and disabling pain. In the same way, at the level of Physiotherapy, there is no systematic practice of specific and differentiated treatments designed to modify the risk factors present in the different subgroup risks.
The SPLIT Project aims to improve the quality of the delivery of care provided in three sequential phases:
1) In a first phase (concluded), at referral level, is intended to characterize the clinical results obtained and evaluate the cost effectiveness of the current practice;
2) In a second phase (concluded), to enable General Practitioners and Physiotherapist to implement an innovative model of referral for a stratified Physiotherapy treatment in low back pain patients in primary health care;
3) Finally, we intend to compare the clinical results, cost effectiveness and referral of actual practice with the new referral system for the stratified Physiotherapy treatment.
