Trial reportEuropean journal of pain (London, England)2021
Effectiveness of stratified treatment for back pain in Danish primary care: A randomized controlled trial.
Trial report in European journal of pain (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Models of care for managing non-specific low back pain.The Cochrane database of systematic reviews · 2025Pooled it
- Pooled it
- Trial
- Risk-stratified Care Improves Pain-related Knowledge and Reduces Psychological Distress for Low Back Pain: A Secondary Analysis of a Randomized Trial.Clinical orthopaedics and related research · 2025Trial
- Effect of Risk-Stratified Care on Disability Among Adults With Low Back Pain Treated in the Military Health System: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Patients' and clinicians' experiences with stratified exercise therapy in knee osteoarthritis: a qualitative study.BMC musculoskeletal disorders · 2022Trial
- Effectiveness of stratified treatment for back pain in Danish primary care: A randomized controlled trial.European journal of pain (London, England) · 2021Trial
- PRIME - A multilevel intervention for low back pain management in primary care: Protocol for an effectiveness-implementation hybrid type 1 cluster randomized controlled trial.Contemporary clinical trials communications · 2026Article
- Clinically relevant contextual factors for enrolling patients in a pain intervention across multiple health care centers.Implementation science communications · 2026Article
- Prognostic ability of the sTarT back screening tool for disability and pain intensity outcomes in older adults with low back pain seeking chiropractic care: a multi-national external validation study.Chiropractic & manual therapies · 2025Article
- A scoping review on implementation processes and outcomes of models of care for low back pain in primary healthcare.BMC health services research · 2024Article
- Low back pain management in primary healthcare: findings from a scoping review on models of care.BMJ open · 2024Article
- Healthcare provider perspectives on integrating a comprehensive spine care model in an academic health system: a cross-sectional survey.BMC health services research · 2024Article
- Article
- Demographic and clinical characteristics of patients with low back pain in primary and secondary care settings in Southern Denmark.Scandinavian journal of primary health care · 2023Article
- The High Burden of Acute and Chronic Pain in General Practice in French-Speaking Belgium.Journal of pain research · 2023Article
- A Stratified Approach for Managing Patients With Low Back Pain in Primary Care (SPLIT Program): A Before-and-After Study.Annals of family medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA randomized controlled trial (RCT) of stratified care demonstrated superior clinical outcomes and cost-effectiveness for low back pain (LBP) patients in UK primary care. This is the first study in Europe, outside of the original UK study, to investigate the clinical efficacy and cost-effectiveness of stratified care compared with current practice for patients with non-specific LBP.
methodsThe study was a two-armed RCT. Danish primary care patients with LBP were randomized to stratified care (n = 169) or current practice (n = 164). Primary outcomes at 3- and 12-months' follow-up were Roland Morris Disability Questionnaire (RDMQ), patient-reported global change and time off work. Secondary outcomes included pain intensity, patient satisfaction, healthcare resource utilization and quality-adjusted life years.
resultsIntention-to-treat analyses found no between-group difference in RMDQ scores at 3 months (0.5, 95% CI -1.8 to 0.9) or 12 months (0.4, -2.1 to 1.3). No overall differences were found between the arms at 3 and 12 months with respect to time off work or secondary outcomes. Stratified care intervention resulted in significantly fewer treatment sessions (3.5 [SD 3.1] vs. 4.5 [3.5]) and significantly lower total healthcare costs (€) (13.4 [529] vs. 228 [830], p = .002). There was no difference in cost-effectiveness (0.09, 0.05 to 0.13 vs. 0.10, 0.07-0.14, p = .70).
conclusionsThere was no significant difference in clinical outcomes between patients with non-specific LBP receiving stratified care and those receiving current practice. However, stratified care may reduce total healthcare costs if implemented in Danish primary care. SIGNIFICANCE: Stratified care for low back pain based on risk profile is recommended by recent evidence based clinical guidelines. This study is the first broad replication of the STarT Back Trial in Europe. Therefore, the study adds to the body of knowledge evaluating the effectiveness of stratified care for low back pain in primary care, and provides insight into the effects of stratification on clinical practice.
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