Low back pain patients in Sweden, Denmark and the UK share similar characteristics and outcomes: a cross-national comparison of prospective cohort studies

Abstract

BackgroundLow back pain (LBP) is the world’s leading cause of disability and yet poorly understood. Cross-national comparisons may motivate hypotheses about outcomes being condition-specific or related to cultural differences and can inform whether observations from one country may be generalised to another. This analysis of data from three cohort studies explored whether characteristics and outcomes differed between LBP patients visiting chiropractors in Sweden, Denmark and the UK.MethodsLBP patients completed a baseline questionnaire and were followed up after 3, 5, 12 and 26 weeks. Outcomes were LBP intensity (0–10 scales) and LBP frequency (0–7 days the previous week). Cohort differences were tested in mixed models accounting for repeated measures. It was investigated if any differences were explained by different baseline characteristics, and interaction terms between baseline factors and nations tested if strength of prognostic factors differed across countries.ResultsThe study sample consisted of 262, 947 and 453 patients from Sweden, Denmark and the UK respectively. Patient characteristics were largely similar across cohorts although some statistically significant differences were observed. The clinical course followed almost identical patterns across nations and small observed differences were not present after adjusting for baseline factors. The associations of LBP intensity and episode duration with outcome differed in strength between countries.ConclusionsChiropractic patients with low back pain had similar characteristics and clinical course across three Northern European countries. It is unlikely that culture have substantially different impacts on the course of LBP in these countries and the results support knowledge transfer between the investigated countries.

The Swiss chiropractic practice-based research network: a population-based cross-sectional study to inform future musculoskeletal research

“…However, a majority of participant clinicians report "often" managing neck pain with arm pain, low back pain with leg pain, chronic pain conditions, and headaches. The wide range of patient complaints managed by participant clinicians signals an opportunity to conduct research outside of the neck and low back pain paradigm-which is traditionally the case in chiropractic practice-based environments [28][29][30][31][32] . Furthermore, the PBRN provides access to a diverse group of potential patient participants as a majority of participant clinicians reported frequently managing patients 65 years or above, while children aged 4-18 years and ethnic and minority groups were reported as sometimes managed.…”

The Swiss chiropractic practice-based research network: a population-based cross-sectional study of chiropractic clinicians and primary care clinics to inform future musculoskeletal health care research

“…The wide range of patient complaints managed by participant clinicians signals an opportunity to conduct research outside of the neck and low back pain paradigm -which is traditionally the case in chiropractic practice-based environments. [28][29][30][31][32]. Furthermore, the PBRN provides access a diverse group of potential patient participants as a majority of participant clinicians reported frequently managing patients 65 years or above, while children aged 4-18 years and ethnic and minority groups were reported as sometimes managed.…”

Swiss chiropractic practice-based research network and musculoskeletal pain cohort pilot study: protocol of a nationwide resource to advance musculoskeletal health services research

“…13 To help bridge the divide between research and practice, countries such as the UK, Denmark, Sweden, and Australia have engaged in practice-based research and worked with MSK-focused practice-based research networks (PBRNs). [14][15][16] A PBRN is a group of at least 15 primary care settings united under a commitment to advance the science base of clinical care. 17 These 'real-world' clinical research environments allow for sustained collaborations between practitioners, patients, and academicians facilitating the co-creation of relevant research questions and production of clinically applicable results.…”

“…Further contributing to practice gaps is the lack of practice-based data collection in MSK healthcare research 13. To help bridge the divide between research and practice, countries such as the UK, Denmark, Sweden, and Australia have engaged in practice-based research and worked with MSK-focused practice-based research networks (PBRNs) 14–16. A PBRN is a group of at least 15 primary care settings united under a commitment to advance the science base of clinical care 17.…”