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471 FEAR‐AVOIDANCE‐AND ENDURANCE‐RELATED RESPONSES TO PAIN 6 MONTHS AFTER LUMBAR DISC SURGERY: CORRELATIONS WITH THE CORTISOL AWAKENING RESPONSE
Author(s) -
Sudhaus S.,
Möllenberg T.,
Strathmann C.,
Willburger R.,
Schmieder K.,
Hasenbring M.
Publication year - 2009
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/s1090-3801(09)60474-2
Subject(s) - medicine , psychology , gerontology , family medicine
Background and Aims: Several studies have demonstrated the positive effect of evidence-based diagnosis and treatment algorithms on the chronification of low back pain patients. Therefore, in January 2009 the Styrian Government initiated a Disease Management Program for the implementation of guidelines into daily practice in one of Styria’s districts. Methods: Working group (WG) I develops the diagnosis and treatment path based on existing guidelines. WG II adapts this path mainly for outpatients to the existing local medical resources. For early identification of risk patients, a screening tool shall be filled out by patients with pain longer than 6 weeks. A basic information sheet will improve the communication and data management between all health care providers. Changes in financial refunding and an exquisite educational program will facilitate the complex patient’s path. Patients will be included between Oct. 2009 and June 2010. Results: The patient’s path is finished. The Örebro Questionnaire will be the screening tool. Thirty physicians, physioand psychotherapists plus 2 hospitals agreed to support this project actively. An electronic data management is being set up. The evaluation concept will focus on the acceptance of the implementation of guidelines by physicians and patients. Conclusions: Even knowing about the importance of implementing guidelines into daily practice, only small studies managed this successfully. This is the first project supported by the Styrian government, health insurances, physicians association and hospitals aiming this implementation in private practices and hospitals simultaneously. If this project will succeed, it will be a brilliant model for other diseases.