IFOMPT conference: Targeted treatment to specific patient groups is way forward

^{Step change required says Professor Nadine Foster}

Nadine Foster, NIHR professor of musculoskeletal health in primary care at Keele University, said that stratified care, or targeting treatments to subgroups of patients, had huge potential to improve outcomes and increase healthcare efficiency.

But despite many years of research into the topic, little had been achieved, she warned, and an international response was needed.

Addressing the IFOMPT (International Federation of Orthopaedic Manipulative Physical Therapists) conference in Glasgow on 7 July, Professor Foster said that the one-size-fits-all approach did not target treatments at those who might benefit most, diluting their effects.

A ‘sobering’ look at the evidence suggested that there were many isolated studies on single subgrouping approaches, and that research had stalled at the development stage, with no robust results on which to base a change in practice.

She described work at Keele in developing and testing a tool to target treatments for low back pain. The STarT Back approach bases treatment decisions on prognosis of those at risk of poorest outcome, who get more intensive support and therapy, while the IMPaCT study has measured its effectiveness.

She said these studies pointed to a way ahead for all MSK conditions – but that more large-scale research was needed. ‘We need to collaborate internationally,’ she said. ‘We need to stop using single group studies to suggest responders to treatment.

‘Can IFOMPT help make that step change?’