The SCOPiC trial - SCiatica Outcomes in Primary Care
Research type
Research Study
Full title
Stratified Care for Patients with Sciatica and Suspected Sciatica in Primary Care: A randomised trial (the SCOPiC trial - SCiatica Outcomes in Primary Care).
IRAS ID
170282
Contact name
Jacqueline Gray
Contact email
Sponsor organisation
Keele University
ISRCTN Number
ISRCTN75449581
Duration of Study in the UK
3 years, 3 months, 31 days
Research summary
Sciatica is a common problem which has a significant impact on patients and is associated with significant healthcare and societal costs. Current treatments range widely from information and advice, medications, exercise and manual therapy ('hands on' treatment), to more invasive treatments such as spinal injections and surgery. A particular problem for a number of patients with sciatica and suspected sciatica is the current delay in treatment. The wide variation in the management of patients throughout the UK means that some patients are offered unnecessary treatments whilst others are denied timely access to effective treatments. Better, and earlier, identification of patient subgroups in primary care for matched treatments (stratified care) is key to improving the outcomes of sciatica patients. The SCOPiC trial stratified care approach combines information about individual patients' likelihood of recovery (prognostic information) with information from their clinical history and physical examination (clinical indicators of the severity of sciatica) in order to ensure that the right patient gets the right treatment at the right time. Using this systematic procedure, patients with sciatica are grouped into one of three subgroups (referred to as low, medium and high risk) and matched to appropriate and timely treatments with patients at low risk receiving advice and support to self-manage; those at medium risk receiving a course of physiotherapy treatment, and those at high risk being ‘fast-tracked’ (with MRI scan) to spinal specialists. The SCOPiC trial aims to recruit 470 patients with sciatica and will test whether stratified care leads to faster recovery for patients than usual, non-stratified care and better outcomes at 4 and 12 months follow-up, and whether it is cost-effective for the NHS to adopt more widely. A linked qualitative study will determine the acceptability of the ‘fast-track’ pathway to both patients and clinicians.
REC name
West Midlands - Solihull Research Ethics Committee
REC reference
15/WM/0078
Date of REC Opinion
17 Mar 2015
REC opinion
Favourable Opinion