Objective:To justify and describe an integrated rehabilitation programme for patients with chronic low back pain prior to evaluation in a randomized controlled trial.Method:The Template for Intervention Description and Replication (TIDieR) checklist was used as a structural framework for the description of the integrated rehabilitation programme. As a part of the description, the Medical Research Council guidance, ‘Developing and evaluating complex interventions’, was used as a framework to justify the integrated rehabilitation programme.Intervention description:The integrated rehabilitation programme adopts a participatory biopsychosocial approach integrating inpatient activities supported by a multidisciplinary team and learning located within the patient’s own environment. The integrated rehabilitation programme comprises 3 weeks of inpatient stay and 11 weeks of home-based activities. The inpatient part of the programme consists of 38 clinical activities, some of them delivered more than once. The 38 clinical activities were described in an activity sheet developed for this purpose, combining five items from the TIDieR.Conclusion:An integrated rehabilitation programme for patients with chronic low back pain has been justified and described. The intervention description is currently being used for successful structuring and standardization of the content and delivery of the integrated rehabilitation programme in a randomized controlled trial.Trail registration:ClinicalTrials.gov: NCT02884466.
The selected PROMs do not cover the prototypical spectrum of problems encountered in patients with low back pain as defined by the Brief ICF Core Set. The clinical assessment of patients' problems according to the Brief ICF Core Set does not correlate with the scores of matching items from the PROMs.
Background: Patient-reported outcomes are expected to play an important role in patient-centred health care. To capture patients' perspectives, patient involvement in the development of patient-reported outcome (PRO) instruments is essential, but often lacking. This qualitative study explored the perspectives of patients with low back pain, to gain an understanding of how to qualify a patient-centred consultation by using PROs. This was done by exploring patients' perspectives regarding the assessment of functioning and disability as part of the development of a new PRO instrument based on the International Classification of Functioning, Disability and Health Core Set. Methods: Semi-structured focus group interviews with seven patients with low back pain were conducted. Data were analysed by drawing on the Interpretive Description methodology.Results: The analysis revealed three core themes: simplicity, individuality and application. Simplicity represented keeping items to a minimum and avoiding overlaps; individuality implied the need for individualized answers; and application signified that PROs should be utilized during the consultation, and that they can provide useful information for clinical decision-making.
Conclusions:The study provides essential knowledge about elements of importance to patients with low back pain when aiming for a patient-centred consultation using PROs. Furthermore, it underlines the importance of involving patients in PRO development because their perspectives improved the new PRO instrument.
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