Patient-Preference Disability Assessment for Disabling Chronic Low Back Pain

Sanchez, Katherine; Papelard, Agathe; Nguyen, Christelle; Jousse, M.; Rannou, François; Revel, Michel; Poiraudeau, Serge

doi:10.1097/brs.0b013e31819c093b

Cited by 15 publications

(10 citation statements)

References 37 publications

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“…As was previously reported in a cross-sectional analysis of baseline data [21], we found only moderate correlation between changes in the MACTAR score and changes in the QUEBEC score at follow-up, which suggests that both instruments are not redundant and that disability priorities do not totally reflect global disability assessed with pre-determined items. The weak correlation between change in the MACTAR score and change in the VAS for LBP or sciatic pain suggests that patients are able to differentiate between handicap and pain.…”

Section: Discussionsupporting

confidence: 82%

“…Mean age at the time of evaluation was 54.3±15.8 years and mean disease duration 93±92.4 months. Forty-six patients (30.7%) were receiving compensation claims, 68 (45.3%) were on sick leave, and 28 (18.7%) had work-related back pain [21].…”

Section: Resultsmentioning

confidence: 99%

“…In the validation study of MACTAR, a Likert scale was added to quantify changes [19]. In the present work, to reflect the degree of difficulty in performing a priority activity, each item was scored on an 11-point quantitative scale (0–10), the global score ranging from 0 (no disability) to 30 (maximal disability), as was done in the survey assessing patients' disability priorities in systemic sclerosis [20] and disabling CLBP [21]. This global score reflects the burden induced by CLBP in performing activities of daily living that matter most to the patient.…”

Section: Methodsmentioning

confidence: 99%

“…Thus, the MACTAR concept of function may be more comprehensive than that of traditional fixed-item questionnaires and may reveal issues that really matter to the patient. Two recent studies evaluating patient priorities in disability in systemic sclerosis and disabling CLBP suggested that the MACTAR adds useful information about disability [20], [21].…”

Section: Introductionmentioning

confidence: 99%

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McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Sensitivity to Change in Low Back Pain: Influence of Shifts in Priorities

et al. 2011

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ObjectiveTo assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) in chronic low back pain (CLBP) and shifts in patients' priorities of disabling activities over time.MethodsA prospective longitudinal survey of 100 patients (38 males) with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC), Hospital Anxiety and Depression scale (HAD), Fear-Avoidance Beliefs Questionnaire (FABQ), Coping Strategies Questionnaire (CSQ), and pain and handicap visual analogue scales (VASs). Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES) and Standardized response mean (SRM) and effect size (ES) were used to evaluate sensitivity to change of the MACTAR.ResultsThe MACTAR SRM and ES values (SRM = 0.25; ES = 0.37) were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF), most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients); community, social and civic life (22.7%); and domestic life (22.4%). At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated.ConclusionsAlthough the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change.

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Section: Discussionsupporting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Sensitivity to Change in Low Back Pain: Influence of Shifts in Priorities

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“…[14–16] For clinical decision-making in chronic disabling back and/or neck pain, this aggregate evidence may inform policy decisions, but cannot directly inform individual patients who may have widely varying personal values and expectations regarding treatment choices and outcomes. [4, 17, 18] Furthermore, these patients may never know the complex costs of their care and disability that constitute the denominator in the value equation. [19]…”

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confidence: 99%

Patient-centered evaluation of outcomes from rehabilitation for chronic disabling spinal disorders: the impact of personal goal achievement on patient satisfaction

et al. 2012

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BACKGROUND CONTEXT The multiplicity of bio-psychosocial and economic facets of chronic disabling back and/or neck pain complicates treatment outcomes measurement. Our previous work showed that personal functional goal achievement contributed more toward patient satisfaction with outcome than did traditional self-reports of pain and physical function or measured strength, flexibility and endurance among functional restoration program (FRP) graduates with chronic disabling back and/or neck pain. PURPOSE The primary goal was to compare the impact on patient satisfaction of pain and functional goal achievement versus self-reports of pain and physical function. STUDY DESIGN/SAMPLE This was an observational study of all patients with chronic disabling back and/or neck pain completing an FRP between 6/08 and 5/09. OUTCOME MEASURES Prior to treatment, participants recorded personal 3-month goals for: pain, work, recreation and activities of daily living. At least 3 months later, all graduates were sent a follow-up survey displaying the patient’s pretreatment functional goals and eliciting the patient’s assessment of functional goal achievement; current pain magnitude, “satisfaction with the overall results for your pain problem;” and responses to the SF-36v2 Physical Functioning subscale (PF-10). METHODS Pain goal achievement was calculated as the difference between the pre-treatment pain goal and follow-up pain magnitude. Linear regression was used to evaluate the associations between satisfaction and four variables (follow-up pain; PF-10; pain goal achievement; function goal achievement), individually and then together in a full model. RESULTS Of the 82 patients surveyed, 62 responded completely. Mean age was 44 years, with 48% female and 35% on worker’s compensation. The model R2 combining all four variables explained 0.6033 of the variance in satisfaction. Each variable by itself was significantly related to patient satisfaction at p < .001, but the overlap in association was large. The unique contributions (R2) to the variation in satisfaction were: function goal achievement: 0.0471; PF-10 score: 0.0229; pain magnitude: 0.0178; and pain goal achievement: 0.0020. CONCLUSIONS At least 3 months after treatment, function goal achievement had by far the greatest impact on patient satisfaction, followed by PF-10 score, pain magnitude, and finally, pain goal achievement. Functional goal achievement has great potential as a tool for patient-centered treatment decision-making and outcomes measurement for people with chronic disabling back and/or neck pain and their health care providers.

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Measures of function in low back pain/disorders: Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI), Progressive Isoinertial Lifting Evaluation (PILE), Quebec Back Pain Disability Scale (QBPDS), and Roland‐Morris Disability Questionnaire (RDQ)

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et al. 2011

Arthritis Care & Research

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Patient-Preference Disability Assessment for Disabling Chronic Low Back Pain

Cited by 15 publications

References 37 publications

McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Sensitivity to Change in Low Back Pain: Influence of Shifts in Priorities

McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Sensitivity to Change in Low Back Pain: Influence of Shifts in Priorities

Patient-centered evaluation of outcomes from rehabilitation for chronic disabling spinal disorders: the impact of personal goal achievement on patient satisfaction

Measures of function in low back pain/disorders: Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI), Progressive Isoinertial Lifting Evaluation (PILE), Quebec Back Pain Disability Scale (QBPDS), and Roland‐Morris Disability Questionnaire (RDQ)

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