Implementation of a virtual hospital model of care for low back pain (Back@Home)

Abstract

Background: Hospitalisations for low back pain (LBP) place a significant burden on healthcare systems. Virtual hospitals help prevent hospital admissions, but their impact on the health outcomes of patients with LBP remains unclear.   Purpose: This study aims to compare health service and patient-reported outcomes of people presenting to ED with LBP before and after the implementation of a virtual hospital model of care for LBP.   Methods: This is a hybrid effectiveness-implementation type-I study. Patients diagnosed with non-serious low back pain requiring admission were referred to the 'Back@Home' virtual back pain service. This program used a mix of virtual care methods, including telephone calls, video calls, SMS, email, and applications such as Physitrack for providing exercise programs. Outcomes will be compared before and after the implementation of the virtual hospital.   Results: From December 2021 to July 2024, a total of 107 inpatients pre-implementation of Back@Home and meeting virtual admission criteria were recruited. 198 patients admitted through Back@Home were also recruited to complete the online survey. A total of 155 (51%) patients completed the 2-week follow-up survey. The mean (SD) pain intensity (4.2 [2.5] vs 5.6 [2.6]), physical function (20.5 [6.6] vs 14.6 [8.9]) and satisfaction (7.8 [2.3] vs 7.6 [2.6]) were significantly better in the virtually admitted patients compared to the traditionally admitted cohort. The complete results including the between-group differences for health service outcomes will be presented at the conference.   Conclusions: This study provides preliminary evidence Back@home provides equivalent or better patient-reported outcomes compared to the traditional hospital for LBP.