Virtual Care for Low Back Pain: Perspectives from Ontario Healthcare Providers

Marcia Correale, Leslie Soever, Christian Veillette, Silvi Groe, Raja Rampersaud, Fiona Webster, Andrew Courchene, Anthony Perruccio
Purpose:

The study aimed to understand Health-Care Providers’ (HCPs) experiences and preferences regarding IPC and VC for LBP. The specific objectives were:

  1. To assess HCP confidence in conducting LBP assessments and management via VC.
  2. To evaluate whether VC versus IPC encompasses key elements including compassion, empathy, efficiency, confidentiality, and equity.
Methods:

All 155 HCPs involved in Ontario’s RAC-LBP program were invited to complete a questionnaire through REDCap software. The questionnaire, gathered data on HCP demographics, practice characteristics and their experiences with both VC and IPC, specifically focusing on patient education, empathy, physical examination confidence, privacy, efficiency, and equity.

Results:

Response rate was 62% (96/155). Respondents were 60% male and 40% female and there was representation from all regions in Ontario. Seventeen percent of HCPs did not use VC for LBP assessment and management, while others employed either telephone (17%), videoconference (16%), or both (52%). Key enablers for VC included reliable internet access, suitable devices, and patient willingness. Barriers included technological challenges for patients and HCP discomfort with VC. Before the pandemic, only 3% of respondents preferred videoconferencing, compared to 61% during lockdown and 39% afterward.  HCP confidence in performing standardized virtual LBP examinations increased significantly from pre-pandemic levels (31% confident) to current times (83% confident). Most respondents (86%) agreed that videoconferencing allowed them to assess patients with empathy, though IPC was rated higher (99%). Regarding equitable access to care,  51% believed IPC was more equitable, while 43% found both methods equally equitable.

Conclusion(s):

While our findings point to an overall preference by HCPs for IPC for assessment and management of LBP, it appears that VC presents opportunities for a patient-centered, hybrid model of care post pandemic. Overall, HCP confidence with VC was increased from pre-pandemic to current times when standardized training was available. Provision of compassionate care by VC was identified as achievable, however, issues of equitable access related to VC warrant further exploration.

Implications:

Our findings suggest that an optimal hybrid VC/IPC model may have the potential to enhance LBP management and support secondary prevention of chronic LBP. When combined with data from patient perspectives, results will inform the development of scalable, empathetic care models tailored to the needs of both patients with LBP, and providers.

Funding acknowledgements:
Canadian Institutes of Health Research (CIHR) Catalyst Grant: Quadruple Aim and Equity - CMA Foundation UHN - Toronto Western Hospital
Keywords:
Virtual Care
Low Back Pain
Advanced Practice
Primary topic:
Musculoskeletal: spine
Second topic:
Service delivery/emerging roles
Third topic:
Primary health care
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
University Health Network (Toronto Western Hospital) - Ethics Committee
Provide the ethics approval number:
22-5611 (9-Feb-23)
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

Back to the listing