To develop a Swedish patient centered coordinated care pathway (P3C) for managing patients with low back pain in primary care.
A national work group was formed consisting of representatives from all regional healthcare organizations in Sweden and included all relevant healthcare professions, academia, and patient organizations. A mixed methods iterative design and consensus approach was applied in the development of the P3C pathway.
As a foundation, patient interviews along with a review of literature was conducted investigating patient experiences and challenges with healthcare for LBP that should be addressed. In addition, earlier regional care programs, pathways, and guidelines in Sweden along with recent systematic reviews and meta-analyses provided a basis for updating evidence-based clinical recommendations as well as constructing flowcharts and tools supporting the practical use of the national P3C pathway. National healthcare data registry-based indicators were constructed to evaluate care pathway quality outcomes. In a final step, an open consultation period allowed for critical review and feedback from the public, patient organizations, healthcare professional organizations, academia and policy makers as a final iteration of revision and consensus. The P3C pathway was published online in November 2023: https://vardpersonal.1177.se/Blekinge/kunskapsstod/vardforlopp/landryggsbesvar-hos-vuxna
Essential factors for integrating best praxis according to scientific evidence and patient and healthcare professional perspectives were identified to establish a Swedish national P3C pathway for LBP. Future research will evaluate potential improvements in healthcare quality outcomes and effectiveness of dissemination and implementation strategies.
Future implementation will involve each healthcare region in Sweden creating local multidisciplinary work groups performing gap analyses, implementing local action plans and administrating future follow-up of the P3C pathway in collaboration with the national work group. An implementation of the P3C pathway may lead to reduce healthcare and societal costs, shorter waiting times, more rational use of healthcare resources, prevention of over-, under- and incorrect treatment and better clarity about patient-practitioner collaboration and patient self-care.
Patient centered and coordinated care
National guidelines
