Research at Keele Discovering Excellence | Page 24

Discovering Excellence | Primary Care

Primary Care
Rhian Hughes
Better Patient Outcomes
Key back pain trial paves the way for improved patient outcomes
A new primary care approach to
dealing with musculoskeletal pain
called “stratified care” – which
identifies the right treatment
according to a person’s need, and
ensures treatment is provided in the
right place and by the most
appropriate health professional – is
one of the key outcomes from the
pioneering research work taking
place at the award-winning Arthritis
Research UK Primary Care Centre of
Excellence based at Keele
University. The ‘STarT Back trial’ has
resulted in significant improvements
in patients’ pain and function – as
well as significant cost-savings for
the NHS.
An estimated 20% of UK adults
consult their general practitioner
(GP) each year with a
musculoskeletal problem,
accounting for 1 in 6 GP
consultations, 8.8 million
physiotherapy consultations, and
over 3.5 million calls to emergency
services. Musculoskeletal problems
represent the single largest group
of chronic conditions for which
patients consult their GPs.
Osteoarthritis is the most common
reason for loss of function and
disability among older people, while
back pain is the commonest reason
for sickness absence and work loss
among younger people.

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Keele’s Institute of Primary Care
and Health Sciences hosts the
Arthritis Research UK Primary Care
Centre of Excellence. It delivers a
world-leading research programme
which highlights the importance of
musculoskeletal conditions to
individuals and to society by
demonstrating the extent of
musculoskeletal pain in the
population, the extent to which
such conditions cause increasing
health and social care burden and
costs, and the impact which pain
has on individuals through loss of
function and increasing disability.
The work involves researching ways
of preventing musculoskeletal
conditions from starting, getting
worse, or limiting people in their
daily lives and activity; developing
new approaches to selfmanagement and treatment of
these conditions by GPs and
physiotherapists in particular, and
shifting the perception that
musculoskeletal conditions are an
inevitable consequence of growing
old by taking a more positive
approach where the symptoms of
pain and disability can be
addressed more directly.

The Centre of Excellence is one of
only eight members of the National
Institute of Health Research (NIHR)
National School of Primary Care
Research and has over £35 million
in current grant income, from
prestigious funders such as the
National Institute of Health
Research, the Medical Research
Council, Arthritis Research UK and
the Wellcome Trust. The centre also
train the primary care researchers
of the future. Over 20 of the
Centre’s staff hold prestigious,
externally-funded Research
Fellowships, from doctoral, to
post-doctoral to professor levels.
Rhian Hughes, deputy director at
the centre, summarises the aims of
the research programme in this
important area. “Our mission is to
identify ways to reduce chronic
musculoskeletal pain in individuals
and the population. We are trying
to achieve this by understanding
the causes, course and
consequences of musculoskeletal
pain; identifying the best ways in
which GPs and physiotherapists can
assess, prevent and treat patients;
improve the content and delivery
of primary care in order to optimise
outcomes for patients with pain
and musculoskeletal conditions
and then disseminate our research
in a way that raises awareness
and understanding of arthritis
and its consequences amongst
patients, health practitioners and
policy makers.”