Abstract
Tertiary care centres continue to experience over-utilisation of diagnostic imaging services for lower back pain cases that may not be required. Moreover, these services may require additional time and consequently delay access to services that offer conservative management, i.e., physiotherapy, and hence, increase the direct and indirect costs with no added quality of care. A logic model was developed based on qualitative and quantitative studies that explains the plan and process evaluation strategies to reduce imaging for lower back pain in tertiary hospitals. Logic models are useful tools for defining programme components. The delivery of the components is ensured by well-defined process evaluations that identify any needed modifications. The proposed logic model provides a road map for spine clinics in tertiary care hospitals to decrease the number of patient referrals for magnetic resonance imaging and waiting times for consultations and services and promote early access to physiotherapy services.
Highlights
There is consensus in international guidelines against the use of imaging for routine diagnostic tests of lower back pain [1,2,3,4,5,6], several studies have identified an increase in imaging referrals for diagnostic testing [7,8,9]
Some studies [10,11] have concluded that magnetic resonance imaging (MRI) lacks the capacity to identify the primary pathology, and others have reported that imaging unnecessarily exposes patients to radiation [12]
The logic model presented here is based mainly on the findings of a previous research conducted in a Saudi Arabian tertiary care setting, which involved qualitative interviews with patients, physiotherapists and spine surgeons [13], as well as quantitative analyses to test the feasibility and acceptability of using the expertise of a physiotherapist to screen all patients referred to a spine clinic [19]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Successful implementation of this logic model will result in efficient utilisation of spine clinic
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
