Alberta Back Care Pathway (ABCp) for Low Back Pain Management Using Guideline-Based Interventions in Primary Care

What this Trial Is About

Low back pain (LBP) causes increasing pain, disability, addiction, and healthcare costs, especially in Alberta where family physicians face barriers in providing effective, guideline-based care. These barriers include lack of training, limited low-cost access to treatments, and insufficient time and reimbursement. The Alberta Back Care Pathway (ABCp) was developed with input from patients, providers, and scientists to offer family physicians a common, guideline-based approach to assess and manage LBP patients effectively in daily practice. The ABCp trains physicians to categorize patients into five groups, each with evidence-based interventions that can be offered at no or low cost to patients and minimal cost to the healthcare system. The study compares the ABCp intervention to usual care in a multi-clinic, controlled, non-randomized stepped-wedge design. The intervention includes patient education, structured exercise programs, and decision-making tools to reduce low-value care. Enrollment lasts one year, followed by a one-year follow-up, with training provided for clinicians and possible telehealth delivery of the GLA:D Back program. Participants will be assessed using ABCp categories and followed for healthcare resource use, quality of life, and opioid use. Data collected include the number of visits to family physicians, specialist referrals, and imaging requests over about 30 months. Quality of life is measured with patient-reported outcomes, and opioid prescription data are tracked. The study aims to reduce healthcare costs and improve outcomes through guideline-based care, with a total project duration of about 2.5 years including pre-implementation activities, enrollment, and follow-up.

Alberta Back Care Pathway (ABCp)