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Randomized Controlled Trial
. 2019 Jun;33(3):226-235.
doi: 10.1007/s00482-019-0362-6.

[Effectiveness of a risk-tailored short intervention to prevent chronic low back pain : A cluster-randomized study in general practice]

[Article in German]
Jean-François Chenot  1 , Michael Pfingsten  2 , Ulf Marnitz  3 , Klaus Pfeifer  4 , Thomas Kohlmann  5 , Gabriele Lindena  6 , Carsten Oliver Schmidt  7
Affiliations
Randomized Controlled Trial

[Effectiveness of a risk-tailored short intervention to prevent chronic low back pain : A cluster-randomized study in general practice]

[Article in German]
Jean-François Chenot et al. Schmerz. 2019 Jun.

Abstract

Background: A subgroup of patients with acute low back pain (LBP) will develop chronic LBP. Risk factors summarized as yellow flags are fear-avoidance beliefs, depression, catastrophizing, and work-related problems.

Objective: The aim was to evaluate the effectiveness of screening for yellow flags in general practice followed by a risk-tailored group intervention compared to care as usual.

Methods: This is a cluster-randomized controlled trial in 35 general practices with 354 patients with acute LBP. Information or a standardized group intervention was offered to patients in the intervention group according to the screening algorithm with a short questionnaire for physical and psychosocial risk factors for chronic LBP. Standardized group information contained education concerning back pain and strategies for physical activities and planning of actions. Primary outcome was functional capacity assessed after 6 and 12 months with a questionnaire. Secondary outcomes were pain severity, fear avoidance beliefs, depression score, self-rated health and health service utilization.

Results: The intervention had no clinically relevant effect on the primary outcome functional capacity and secondary outcomes, although the course was consistently slightly better. Adherence to the offered intervention was low. Health service utilization was not altered to a relevant extent. A subgroup analysis comparing adherent and non-adherent patients showed a consistently better course of adherent patients.

Conclusions: A risk-tailored short intervention to prevent chronic LBP in general practice had no significant impact on the clinical course compared to care as usual. A subgroup analysis comparing adherent and non-adherent patients suggests that it is possible to have a positive impact on patient-relevant outcomes.

Keywords: Chronic pain; General practice; Low back pain; Prevention; Randomized controlled trial.

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References

    1. Spine (Phila Pa 1976). 1999 Dec 1;24(23):2484-91 - PubMed
    1. Eur J Pain. 2000;4(3):259-66 - PubMed
    1. Eur Spine J. 2003 Apr;12(2):149-65 - PubMed
    1. BMJ. 2003 Aug 9;327(7410):323 - PubMed
    1. Pain. 1992 Aug;50(2):133-49 - PubMed

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