Primary Care Centre Versus Arthritis

Disease - Osteoarthritis, back pain, polymyalgia rheumatica

Lead applicant - Elaine Hay

Organisation - Keele University

Type of grant - Centre of Excellence Full

Status of grant - Active

Amount of the original award - £2,200,000

Start date - 1 April 2013

Reference - 20202

Public Summary

What are the aims of this research?

The Primary Care Centre at Keele University has been renewed for a second period of five years. Achievements in the first five years of the centre include the development of the STarT Back screening tool, which that targets specific physiotherapy treatment for selected people with low back pain. This tool, which has been taken up by GP surgeries across the UK, has been shown to lead to increased patient satisfaction and reduced healthcare costs.

Over the next five years the centre will concentrate its efforts on research which aims to match patients with the most appropriate treatments, making sure that those patients who can manage their condition themselves get more support, and that those who need more input from their medical team receive the care they need.

Why is this research important?

20% of adults will consult their GP each year with a musculoskeletal problem, accounting for 1 in 6 GP consultations, 8.8 million physiotherapy consultations, and over 3.5 million calls per year to emergency services. Musculoskeletal problems represent the single largest group of chronic conditions for which patients consult their GPs. How to manage this enormous work-load poses a big challenge for primary care services. Whilst many patients have mild complaints which could be self-managed with appropriate support, some have more serious or persistent problems that would benefit from treatments which research has shown to work, such as exercise programmes or pain management. The problem is that the traditional medical modelof primary care, where treatment decisions are guided by the Doctor making a specific diagnosis, has not helped identify who could be supported to self-manage and who needs more treatment. There is wide variation in care – some patients are offered unnecessary treatments whilst others are denied access to effective treatments. This makes primary care inefficient and does not get the right patient to the right treatment at the right time.

How will the findings benefit patients?

The hope is that this research will underpin a shift in the way musculoskeletal disorders are managed in primary care management, with an increasing emphasis on pro-active, positive approaches to seeking out patients needing more support for self-management, as well as those needing more input from doctors or other health professionals, and developing and testing new ways of organising primary care which better meets these needs and takes the physical, psychological and social needs of patients into account.