AUTHOR=Ibsen Charlotte , Maribo Thomas , Nielsen Claus Vinther , Hørder Mogens , Schiøttz-Christensen Berit 

TITLE=ICF-Based Assessment of Functioning in Daily Clinical Practice. A Promising Direction Toward Patient-Centred Care in Patients With Low Back Pain

JOURNAL=Frontiers in Rehabilitation Sciences

VOLUME=2

YEAR=2021

URL=https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2021.732594

DOI=10.3389/fresc.2021.732594

ISSN=2673-6861

ABSTRACT=<p><bold>Background:</bold> Patient-centred care has received increased attention in recent years. Patient-Reported Outcomes (PROs) and shared decision-making are key components of Patient-Centred care. Low back pain (LBP) is a complex symptom affected by multiple, interacting factors. Therefore, evidence strongly recommend a biopsychosocial and patient-centred approach in the assessment and management. The International Classification of Functioning, Disability and Health (ICF) provide a biopsychosocial model for describing functioning and disability. ICF is widely acknowledged, but implementation into clinical practice is lacking. To support the use of a biopsychosocial and patient-centred approach in daily clinical practice among patients with LBP we developed a practice-friendly tool based on ICF; the LBP assessment tool.</p><p><bold>Objective:</bold> To compare an ICF-based assessment facilitated by the LBP assessment tool with standard care in terms of the use of PROs and shared decision-making in order to promote patient-centred care in patients with LBP.</p><p><bold>Methods:</bold> A non-randomized controlled design was used. Eligible patients were allocated to one of two groups: the ICF group, assessed with the LBP assessment tool or the control group, assessed with a conventional LBP assessment. Primary outcome includes use of PROs. Secondary outcomes include use of a graphical overview displaying the patient profile and shared decision-making. A patient evaluation questionnaire was used to collect data.</p><p><bold>Results:</bold> Seven hundred ten patients were assessed for eligibility of whom 531 were allocated to the ICF group (<italic>n</italic> = 299) or the control group (<italic>n</italic> = 232). A significantly higher use of PRO data (<italic>p</italic> &lt; 0.00) and the patient profile (<italic>p</italic> &lt; 0.00) was reported in favor of the ICF group. Patients in the ICF group also experienced being more involved in decision-making (<italic>p</italic> = 0.01).</p><p><bold>Conclusions:</bold> This study showed that a functioning assessment, by means of the LBP assessment tool, increased use of PROs and shared decision-making when compared to a conventional LBP assessment. Additionally, this study demonstrated that routine use of ICF-based PRO data and shared decision-making promoted patient-centred care in patients with LBP. The LBP assessment tool may be a strong candidate for a user-friendly ICF-based tool with the potential to support health professionals in a shift toward a biopsychosocial and patient-centred approach to patients with LBP.</p>