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Low back and neck pain are among the leading causes of medical visits, lost productivity and disability. There is an urgent need to identify ways of helping patients with acute spine pain while guiding practitioners towards high-value care. The Spine Pain INtervention to Enhance Care quality And Reduce Expenditure (SPINE CARE) enrolled 2,971 patients from 33 centers nationally and tested the impact of a two new care models. The first was a risk-stratified, multidisciplinary intervention called the Identify, Coordinate, and Enhance [ICE] care model that combines physical therapy, health coach counseling, and consultation from a specialist in rehabilitation. The second was an individualized postural therapy approach, which combines physical therapy with building self-efficacy and self-management. Both interventions resulted in significant improvements in pain-related disability that were sustained at 12 months. The ICE intervention also reduced health spending. NCT03083886

Principal Investigators: Niteesh Choudhry, MD, PhD

Biopsychosocial Intervention or Postural Therapy in Patients With Spine Pain—Reply

Hsu E, Milstein A, Choudhry N


2023 April 25

Effect of a Biopsychosocial Intervention or Postural Therapy on Disability and Health Care Spending Among Patients With Acute and Subacute Spine Pain: The SPINE CARE Randomized Clinical Trial

Choudhry NK, Fifer S, Fontanet CP, Archer KR, Sears E, Bhatkhande G, Haff N, Ghazinouri R, Coronado RA, Schneider BJ, Butterworth SW, Deogun H, Cooper A, Hsu E, Block S, Davidson CA, Shackelford CE, Goyal P, Milstein A, SPINE CARE Investigators, Crum K, Scott J, Marton K, Silva FM, Obeidalla S, Robinette PE, Lorenzana-DeWitt M, Bair CA, Sadun HJ, Goldfield N, Hogewood LM, Sterling EK, Pickney C, Koltun-Baker EJ, Swehla A, Ravikumar V, Malhotra S, Finney ST, Holliday L, Moolman KC, Coleman-Dockery S, Patel IB, Angel FB, Green JK, Mitchell K, McBean MR, Ghaffar M, Ermini SR, Carr AL, MacDonald J 


2022 December 20

Design of the Spine Pain Intervention to Enhance Care Quality And Reduce Expenditure Trial (SPINE CARE) study: Methods and lessons from a multi-site pragmatic cluster randomized controlled trial

Choudhry NK, Fontanet CP, Ghazinouri R, Fifer S, Archer KR, Haff N, Butterworth SW, Deogun H, Block S, Cooper A, Sears E, Goyal P, Coronado RA, Schneider BJ, Milstein A

Contemp Clin Trials

2021 October 22

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