Chief Investigator:

Prof Elaine Hay

Principal Investigator:

Prof Nadine Foster

Study Co-ordinator:

Dr Jonathan Hill, Dr Ricky Mullis

Funder name / reference number: Health Foundation Ref ID 346/4540, Central and Eastern Cheshire Primary Care Trust (07/H1017/143)
UKCRN Study portfolio: ISRCTN55174281
Year 2009-2012

Study design

The IMPaCT Back Study (IMplementation to improve Patient Care through Targeted treatment) prospectively compared separate patient cohorts in a preintervention phase (6 months of usual care) and a postintervention phase (12 months of stratified care) in family practice, involving 64 family physicians and linked physical therapy services. A total of 1,647 adults with low back pain were invited to participate.

Primary objective

We aimed to determine the effects of implementing risk-stratified care for low back pain in family practice on physician’s clinical behaviour, patient outcomes, and costs.


Stratified care entailed use of a risk stratification tool to classify patients into groups at low, medium, or high risk for persistent disability and provision of risk-matched treatment.