Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Jun;66(6):925-33.
doi: 10.1002/acr.22252.

Design and development of a decision support package for low back pain

Shilpa Patel  1 , Anne Ngunjiri, Harbinder Sandhu, Frances Griffiths, Jill Thistlewaite, Sally Brown, Tim Friede, Joanne Lord, Colin Tysall, Mark Woolvine, Martin Underwood
Affiliations
Free PMC article
Review

Design and development of a decision support package for low back pain

Shilpa Patel et al. Arthritis Care Res (Hoboken). 2014 Jun.
Free PMC article

Abstract

Objective: To develop a decision support package for people with low back pain (LBP) referred for physiotherapy.

Methods: We used a program of exploratory work, including literature reviews, a Delphi study, a nominal group with physiotherapists, focus groups with patients, and secondary analysis of existing interview data.

Results: We developed an information booklet describing the evidence-based treatment modalities available in a physiotherapy department. This includes data on likely benefits and risks and how the intervention is delivered. The booklet specifically addresses questions identified as important in our exploratory work. Space is provided for patients to note down the pros and cons of each treatment and what matters to them when choosing treatments. The patient is subsequently directed to a section that explores any gaps in knowledge, values, support, and choice before finally clarifying if a treatment decision is possible. At this stage they are encouraged to note down any questions or concerns they have to be discussed at the first physiotherapy consultation. This overall package includes patient material in the form of a booklet posted prior to their consultation, plus the enhanced consultation with the specially trained physiotherapist. Patients then receive their chosen treatment. In addition we developed a training package for physiotherapists that explains the content of the booklet and supports them in using informed, shared decision making in their consultation.

Conclusion: This package has the potential to improve effectiveness of treatments and patient satisfaction for LBP by facilitating patient choice and therefore matching patients more effectively to different treatments.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Details of questions asked in Delphi round 1.
Figure 2
Figure 2
Flow chart of decision aids search strategy. RCT = randomized controlled trial.
Figure 3
Figure 3
Flow chart of qualitative studies selection. NSLBP = nonspecific lower back pain; RCTs = randomized controlled trials.
See this image and copyright information in PMC

References

    1. Savigny P, Kuntze S, Watson P, Underwood M, Ritchie G, Cotterell M, et al. Low back pain: early management of persistent non-specific low back pain. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners; 2009. - PubMed
    1. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84:95–103. - PubMed
    1. Troup JD, Clinical Standards Advisory Group . Back pain and epidemiology review: the epidemiology and cost of back pain. London: Her Majesty's Stationery Office; 1994.
    1. Waddell G, Burton AK. Occupational health guidelines for the management of low back pain at work: evidence review. Occup Med. 2001;51:124–35. - PubMed
    1. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354:581–5. - PubMed

Publication types

MeSH terms

Associated data

LinkOut - more resources