Patient Centred Maintenance Care is Here!

Hey everyone, it's Chris again. You're getting me from home today. Unfortunately, I'm down with COVID Just a mild cold strain, nothing too severe, but I've been at home for most of last week with it and I've been hoping to get back into the clinic to record some stuff for you, but I'm not sure when I'm going to be in. Yeah, I really didn't want to miss this one out though, because I just came across this a couple of days ago. It's really, really cool study and really cool tool for you and your patients all around maintenance care. So if you're a chiropractor, you've probably been aware of the Andreas Eklund and his colleagues doing the Nordic Maintenance Care Studies. Really cool series of publications. They've been publishing more and more data on this for the last few years in a row and the stuff they're finding out just keeps getting better and better. So most of us already knew that the Nordic Maintenance studies showed that maintenance care is an effective approach for people with chronic low back pain. Something that a lot of colleagues that I've spoken to weren't aware of though, was that within the group of chronic low back pain, they actually found some people who respond way better than others. And it's possible to subgroup people into different groups because some do way better, some actually seem to do a bit worse. With maintenance care versus just being on their own, it actually seems to increase the pain. So it's really important for us as patient centered practitioners to be able to offer it appropriately and subgroup appropriately. And something they've just published is a really, really simple tool, it's very quick to use that will help you identify those patients who will do well and identify those who won't. And that means that we can give a personalized recommendation, not just say, to every person who has chronic low back pain, you should have some maintenance care. Now we can say based on your schools, based on your care and what I know about you, you, you're a particularly good candidate for maintenance care. You're likely to do much better than the average person with it. So I'm going to share my screen here because I do want to show this. I'll put a link to where you can find this below. Published it, it's out there. It's really, really cool. But let's just show you the questionnaire quickly. So this is a questionnaire. You give this to patients, there are just 10 questions. They score each one from zero to six. That's it. So they Fill this out. They do this at the start of care when you first meet them, then that gives them a score. The really cool thing is, as well as they also then give you a questionnaire. It's just four questions, but essentially this is to work out are they somebody who we should be considering maintenance careful in the first place. And what happens is they get the score up here and if that score is at least 18, there's somebody who is worth having a discussion with. 18 to 21 means okay, they might re worth having maintenance. It depends on their preference. But above 21, I think the maximum score is 48. There's above 21 that we can definitely recommend it and it's likely to be cost effective. So if they score that and they answer yes to these four questions here, then that tells us whether it's useful to do that. The really cool thing as well is based on the answers to different questions. It then guides you as to particular areas you should be looking at to help this patient. So you'll see on the top that there are some, some codes here and that tells you which area of this complaint that they're measuring. And then you can go down and go, oh, you know what? They scored particularly high on the life control ones. Let's have a look at that. Let's explore that more with them. Or maybe this is affecting their emotional state more that affective distress. So if you get them to fill this out, then when you have the initial consultation, you're much more informed as to how this is impacting their life, maybe what their goals are going to be and the areas that you need to show you can address in order to get them back to where they want to be. So it's a really simple tool. I love that they've boiled it down to 10 questions. It's super quick for patients to fill out. I'm kind of annoyed that I'm stuck at home at the minute because I'm really looking forward to getting into clinic and trying this out. I've already spoken to a colleague who has and has already found it's really helpful talking about maintenance care from a perspective of this is something that we can be confident is right for you instead of this is just a recommendation we give everybody because we all know that there are people who overuse maintenance care. And a lot of us get a bit funny about it because we don't want to be one of those chiropractors. This is the perfect way to prove that we're not that and that we're recommending personalized patient centered care. So I'll put the link below. Please check out the whole study. It's got a lot of great info and how you use it as well. But if you want to just use the questionnaire, I'll put both links below. Check those out, let me know how you get on. I'm really excited about this because this is something that the professions needed for decades to actually be able to spot this. And now we're getting not just the research saying it's useful, but the tools to make sure we do a really good job. So check that out. Let me know how you get on as well. Myself and Andreas and many of us would love to hear about your experiences with this tool because Andrea said in the thread just the other day, they like putting this stuff out, they're excited by it. But if we as clinicians are not actually using this, what's the point? So let's not just go, oh, there's loads of research out there, thank you, researchers. That's really, really useful. Let's actually use the tools they're giving us to give our patients better care.