Interdisciplinary Intervention Model

Most of the primary care clinics in Quebec and in the world do not offer an interdisciplinary intervention to treat individuals with LBP [66-71]. However, four CSSSs in Quebec offer an interdisciplinary intervention program to manage individuals with CLBP. In this program, individuals with LBP are first seen by general practitioners (GPs) who refer the patients to the interdisciplinary team, which includes physicians, nurses, physiotherapists, and clinical psychologists. The team delivers pharmacological and non-pharmacological treatments to manage individuals with CLBP for six months. The team members follow an algorithm (McGill Spine Care Algorithms) to guide the referral process to another health professional or to another healthcare level.
CECP has built a network of patients, researchers, clinicians and decision-makers to optimize the health care services for individuals with chronic pain phsi . “CECP care model favors the establishment of an integrated services network and involves consolidating and strengthening the primary level of care and ensuring access (clinical pathways) to secondary and tertiary level care” phsi. Furthermore, the CECP model is established to help prevent chronicity, treat pain, and empower self-management phsi. Improving health services at the primary care level through the best practices of CLBP management may minimize unnecessary referrals to other their levels, shorten waiting time, and ensure that individuals receive the care they need to address particular aspects of health and well-being (physical, mental, and development of self-management
The literature on the barriers and gaps in the interdisciplinary care for LBP is limited. However, many studies have evaluated the barriers and gaps in CP management; CLBP is the most common type of CP. The identified gaps and barriers can be categorized into clinician and organizational barriers. The gaps and barriers that relate to clinicians include: 1) lack of CP knowledge and management, 2) lack of CP management training, medical and allied health schools give little time to this topic, 3) lack of confidence in CP treatment among clinicians [74-81], 4) lack of communication between both clinicians and levels of care and lack of coordination [82, 83], 5) clinicians fail to follow the clinical guidelines. Approximately, half of the physicians never or occasionally used treatment guidelines and less than half used formal pain diagnostic procedures [84]. Lastly, 6) there are three issues related to CP referral: The first issue is that physicians do not know when and where to refer a patient to another level of service; the second relates to the purpose of referral (i.e. is it for diagnosis or treatment?); and the last issue relates to continuing treatment after discharge [82,