Stratified Care for Musculoskeletal Conditions in Primary Care: A Prospective Sequential Cohort Study of the STarT MSK Tool and the eSELF-MSK Virtual Self-Management Program

Background/Objectives: To compare changes in pain intensity, musculoskeletal health and function, and psychosocial risk between usual care and implementation of a bundled STarT MSK-guided care pathway among low-risk adults.

Methods

In this non-randomized sequential cohort study, the usual-care cohort was recruited before clinician training and pathway implementation, followed by recruitment of the stratified-care cohort. Both cohorts comprised adults classified as low risk by the STarT MSK Tool. The pathway combined risk classification feedback, clinician training, one in-person physiotherapy assessment, education and exercise prescription, supported self-management, and five weekly virtual consultations. NPRS and MSK-HQ, the prespecified primary outcomes, and ÖMPQ, a prespecified secondary longitudinal outcome, were assessed at baseline, 6 weeks, and 12 weeks and analyzed using linear mixed-effects models; satisfaction was a secondary outcome assessed at 12 weeks.