Should We Give Detailed Advice and Information Booklets to Patients With Back Pain?

Little, Paul; Roberts, Lisa; Blowers, Helen; Garwood, Judit; Cantrell, Ted; Langridge, John; Chapman, Judith

doi:10.1097/00007632-200110010-00003

Cited by 57 publications

(6 citation statements)

References 24 publications

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“…Results from RCT on their effectiveness in LBP are mixed (3,8,11,35,(40)(41)(42)(43)(44) and these prior studies have included patients with existing LB symptoms, either acute or chronic LBP. We are not aware of comparable RCT about LB-specific self-care information for non-sick-listed employees in an OH setting.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Rantonen¹,

Vehtari²,

Karppinen³

et al. 2013

Scand J Work Environ Health

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Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial by Rantonen J, Vehtari A, Karppinen J, Luoto S, Viikari-Juntura E, Hupli M, Malmivaara A, Taimela S Respondents with mild LB symptoms were randomized into the Back Book (control) Back Book+Advice (intervention) groups. Both occupational health (OH) interventions were effective, but supplementary oral information was not more effective compared to the booklet alone. Policy implications: Patient advice is important in the OH setting, but we need more evidence of the effectiveness of various types of information. Original article Scand J Work Environ Health. 2014;40(2):156-166. doi:10.5271/sjweh.3398 Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial by Jarmo Rantonen, MD, 1 Aki Vehtari, DrTech, 2 Jaro Karppinen, MD, PhD,1, 4 Satu Luoto, MD, PhD, MD, PhD, 1 Markku Hupli, MD, PhD, 3 Antti Malmivaara, MD, PhD, 5 Simo Taimela, MD, PhD 6,7 Rantonen J, Vehtari A, Karppinen J, Luoto S, Viikari-Juntura E, Hupli M, Malmivaara A, Taimela S. Face-to-face information combined with a booklet versus a booklet alone for treating mild low-back pain: a randomized controlled trial. Scand J Work Environ Health. 2014;40(2):156-166, doi:10.5271/sjweh.3398 AffiliationObjective The aim of this study was to determine the effectiveness of face-to-face information for the treatment of mild low-back pain (LBP) in an occupational health (OH) setting. MethodsWe conducted a 48-month randomized controlled trial (RCT) with two 1:1 allocated parallel groups of forestry company employees. Eligibility criteria included permanent employment, age <57 years, and mild LBP [visual analogue scale (VAS) 10-34 mm] in a survey. The intervention group received the Back Book, an information booklet on how to manage LBP, with an additional face-to-face review of the booklet by an OH nurse. The control group received the booklet only. Primary outcomes were physical impairment (Roland-Morris 18-item (RM-18) Disability Questionnaire), LBP (VAS 100 mm), health-related quality of life [15-dimensional quality of life (15-D)] during two years and sickness absence (SA) up to four years. Participants were assigned using block randomization with a computer-generated scheme. ResultsThe RCT comprised 181 participants (72% male, mean age 44 years). There were no differences between the treatment arms in any of the primary outcomes at any time point. At 24 months, the mean group differences (intervention versus control) were: RM-18: 0 [95% confidence interval (95% CI) -1-1], VAS: 3 mm (95% CI -3-8), and 15-D 0.00 (95% CI -0.02-0.02). The difference in cumulative sickness absence days at 48 months were -3 (95% CI -28-21) for total and 1 (95% CI -3-5) for LBP specific sick leaves. Exploratory analysis revealed no differences at subgroup-levels either.Conclusions Face-to-face patient information by an OH nurse in addition to a booklet was not more eff...

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Section: Comparison With Previous Studiesmentioning

confidence: 99%

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Rantonen¹,

Vehtari²,

Karppinen³

et al. 2013

Scand J Work Environ Health

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“…Multiple methods of prescription were the most favoured form of prescription used by treating student practitioners at VUOMC at 69%, and resulted in greater compliance (average compliance 61%) than those techniques used individually (average compliance 54%). Little et al 15 found that using the same information in slightly different and more detailed formats results in no reinforcement of instructions, indicating that if multiple methods of prescriptions are used they must mimic each other precisely in content to receive optimal compliance, which was assumed to be the case at VUOMC.…”

Section: Discussionmentioning

confidence: 99%

“…1,11,15,16 To improve the compliance rate at the VUOMC (overall 59%), students need to use more diagrammatic prescriptions concluded that patients will be more compliant when they are extensively instructed, and given more information, clarification and details by their treating practitioner, and will also have improved adherence when patients have a good relationship with their therapist. With all studies indicating that more detailed instructions, and more specifically the use of take-home diagrams enhancing the compliance to PRA, further research could confirm these findings.…”

Section: Discussionmentioning

confidence: 99%

Patient compliance to exercise prescription at the Victoria University Osteopathic Medicine Clinic

Wheller

Gosling

Herman

2006

International Journal of Osteopathic Medicine

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Research has demonstrated a positive relationship between the level of adherence to PRA and recovery from a variety of musculoskeletal conditions, and has shown noncompliance to home-based exercise programs reduces the probability of successful outcome for therapeutic intervention. No previous research has focused on compliance to prescription and methods of prescription used in the osteopathic medicine setting.Objectives: To establish compliance rates at Victoria University Osteopathic Medicine Clinic (VUOMC) to prescribed home-exercises and to assess current practitioner prescription methods at VUOMC.Design: Prospective survey study. Methods:Over a 5 week period, all consenting return patients of VUOMC were surveyed (N = 94) prior to the commencement of their return treatment visit on their adherence to exercises prescribed at the previous treatment using a tool developed by the researchers. Compliance of patients was calculated by comparing the participants' survey markings of prescription, to those recordings of the prescription made by the treating 4 th and 5 th year student practitioners in the participants' case file.Results: Sixty-seven percent of return patients were prescribed PRA and 33% were not. Total compliance rate to PRA was 55(59%) of respondents, with 39(41%) noncompliant. When combining prescription methods into broader categories, Diagrams were used in 15% of cases to instruct patients in PRA compared to Verbal instruction in 80% of cases. Verbal instruction had a total compliance of 41(56%) and non- Research has demonstrated a positive relationship between the level of adherence to exercise programs and recovery from a variety of musculoskeletal conditions. 2-5 It has also been reported that non-compliance to home-based exercise programs reduces the probability of successful outcome for therapeutic intervention. 3 Despite the positive results shown with adherence to PRA, compliance to practitioner prescribed exercise is low, with a 40-50% dropout rate in the first six months. 4 Therefore, as the need for PRA grows, it is important for practitioners to understand which method of prescription will gain them the greatest amount of patient compliance, and in turn increase speed of patient recovery.Numerous factors affect compliance, the degree to which the advice of a health professional is addressed and followed, 4 with several terms (compliance, motivation, adherence and non-compliance) having overlapping boundaries. Compliance can be described as both an attitude, consisting of the willingness or intent to follow the health prescription, or a behaviour that involves the actual carrying out of the prescription. 1 Non-compliance includes reluctance and behaviour characterised by

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“…The provision of a single, credible resource providing evidence-informed messages, underpinned by health policy [5] and designed for use by both health professionals and consumers with LBP, may encourage the adoption of more consistent LBP management in primary care. In this context, an emerging body of evidence points to the benefits of education booklets and pamphlets for improving knowledge and outcomes for consumers with LBP[24]–[28]. A recent systematic review [26] determined that pamphlets based on a biopsychosocial model of pain rather than a biomedical model, were associated with improved consumer beliefs regarding physical activity, pain and consequences of LBP.…”

Section: Introductionmentioning

confidence: 99%

“…A recent systematic review [26] determined that pamphlets based on a biopsychosocial model of pain rather than a biomedical model, were associated with improved consumer beliefs regarding physical activity, pain and consequences of LBP. Further, supporting information with verbal reinforcement from health professionals may improve outcomes to a greater extent [24], [26], provided that the information is not overly detailed [28].…”

Section: Introductionmentioning

confidence: 99%

Translating Evidence for Low Back Pain Management into a Consumer-Focussed Resource for Use in Community Pharmacies: A Cluster-Randomised Controlled Trial

et al. 2013

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BackgroundThis cluster-randomised controlled trial determined the effectiveness of an evidence-based, pamphlet intervention in improving low back pain (LBP)-related beliefs among pharmacy consumers.MethodsThirty five community pharmacies were randomised to three groups: pamphlet+education intervention [n = 11]; pamphlet only intervention [n = 11]; control: usual care [n = 13]. Eligibility requirements for clusters included: community-based pharmacies and proprietor participation consent. Pharmacy consumers (N = 317) aged 18–65 years currently experiencing LBP participated. Intervention group allocation depended on the pharmacy attended. Individual-level outcomes were measured at pre-intervention (T0), at two (T1) and eight (T2) weeks post-intervention and included beliefs about LBP [Back Pain Beliefs Questionnaire (BBQ); Fear Avoidance Beliefs Questionnaire (FABQ)]. Secondary outcomes included pain severity, activity impairment and pamphlet perceived usefulness. Blinding to group allocation included primary investigators, outcome assessors and the statistician. Pharmacy staff and consumers were un-blinded.ResultsOf 35 pharmacies recruited (317 consumers), no clusters were lost to follow-up. Follow-up was available for n = 24 at 2 weeks only; n = 38 at 8 weeks only; n = 148 at both time points, with n = 148+24+38 = 210 analysed (107 excluded: no follow up). Adjusting for baseline scores demonstrated no significant differences in beliefs (2 or at 8 weeks) between pamphlet (with or without education) versus control, or between ‘pamphlet with’ versus ‘without’ education. Work-related fear (FABQ) was significantly lower in consumers receiving pamphlet (with or without education) versus control (difference −2.3, 95%CI: −4.4 to −0.2). There was no significant difference between “pamphlet with” versus “pamphlet without” groups. Consumers receiving the “pamphlet with” reported greater perceived usefulness than consumers receiving the “pamphlet without” (difference 0.9 (95%CI: 0.0 to 1.8)).ConclusionCommunity pharmacies provided a feasible primary care portal for implementing evidence-based information. The associated improvement in work-related LBP-beliefs for consumers receiving the pamphlet suggests this simple intervention may be a useful component of care.Trial RegistrationACTR.org.au ACTRN12611000053921

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Should We Give Detailed Advice and Information Booklets to Patients With Back Pain?

Cited by 57 publications

References 24 publications

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

Patient compliance to exercise prescription at the Victoria University Osteopathic Medicine Clinic

Translating Evidence for Low Back Pain Management into a Consumer-Focussed Resource for Use in Community Pharmacies: A Cluster-Randomised Controlled Trial

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