Collaborative care models embrace the interdisciplinary team approach to care. In one trial of 401 patients with musculoskeletal pain who were randomized to receive either collaborative pain care or usual care at five VA primary care clinics, a care manager worked in conjunction with a pain specialist to manage patients in the collaborative care arm, assess their needs and then refer them to physical, occupational or recreational therapy, following up with the pain specialist on the decisions made.21
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Stratified care models are newer and have less evidence behind them. In one non-randomized, implementation trial published in 2014, 922 patients with low back pain who received care at a family practice clinic were compared with a subsequent group of patients who received a new, stratified back pain intervention called the STarT Back Tool.22 This tool uses questionnaires to help providers identify levels of pain risk and disability so they can target patients for particular interventions. The study showed small, but significant, benefits for patients who used the STarT Back Tool over those receiving typical care, she said.
Susan Bernstein is a freelance journalist based in Atlanta.
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