Reassuring Patients With Low Back Pain in Primary Care Consultations

G, Simonsen; Jensen, Tue Secher; Kongsted, Alice

doi:10.1097/ajp.0000000000000946

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…The present study demonstrates the importance of providing patients with an opportunity to talk about their back pain in-depth, receive tailored advice and interventions that are sensitive to the lived experiences of chronic LBP. A recent study highlighted that efforts to optimise clinician–patient communication improved perceived treatment outcomes in primary care consultations [ 30 ]. Another study investigating the effect of the examination process (history taking and physical examination) on low back pain and disability found that the personalised evaluation process produced improvements in the therapeutic effect of back pain interventions [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

A process evaluation of the Mind Your Back trial examining psychologically informed physical treatments for chronic low back pain

2021

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Background In chronic conditions, such as back pain, the use of interventions that address physical, social and psychological aspects within a biopsychosocial framework are encouraged, however, applying this holistic multimodal approach in physical therapy practice (i.e., chiropractic and physiotherapy) is challenging. To explore the problem of delivering a biopsychosocially informed package of care in physical therapy practice a recent randomised control trial (RCT) called ‘Mind Your Back’ was conducted to evaluate the effectiveness of a combined physical and internet-delivered psychological intervention (psychologically informed physical treatments) compared to standard treatment for improving disability and self-efficacy in people with chronic LBP. The results of the trial indicated no difference between the two intervention groups. Although high-quality RCTs are considered gold standard for effectiveness of interventions, qualitative research methods embedded within a process evaluation framework are also used to reveal other issues and important information that help to explain clinical trial results, and to further the field of digital health interventions research. Therefore, within a process evaluation framework, the aim is to explore participants experiences of the interventions received throughout the Mind Your Back trial which led to a null result. Methods In-line with recommendations for a process evaluation this study used in-depth interviews and qualitative thematic analysis with participants of both arms of the trial 5–6 months after study completion. Semi-structured telephone interviews were conducted with twenty-five participants to explore their experiences of taking part in the Mind Your Back trial. Interviews were conducted in November 2017, transcribed verbatim and data analysed thematically. Results Two main themes were identified: (1) Personalised support and therapeutic alliance are important, and (2) MoodGYM lacked relevant, personalised and tailored support. Conclusion It is important to deliver tailored digital health supports that is personalised and fosters a therapeutic alliance.

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Section: Discussionmentioning

confidence: 99%

A process evaluation of the Mind Your Back trial examining psychologically informed physical treatments for chronic low back pain

2021

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“…Linton et al, conceptualised reassurance as a set of behaviours, both verbal and non-verbal, that practitioners carried out with the aim of reducing concerns and anxiety in patients. Pincus and colleagues followed this with a body of research, including a review of current knowledge, the development of tools to measure and quantify reassurance [7], and subsequently, research that explored the association between reassurance and patient outcomes [8][9][10].…”

Section: Pain and Uncertainty: The Role Of Effective Reassurancementioning

confidence: 99%

Patient-centered consultations for persons with musculoskeletal conditions

2022

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Consultations between practitioners and patients are more than a hypothesis-chasing exploration, especially when uncertainty about etiology and prognosis are high. In this article we describe a single individual's account of their lived experience of pain and long journey of consultations. This personal account includes challenges as well as opportunities, and ultimately led to self-awareness, clarity, and living well with pain. We follow each section of this narrative with a short description of the emerging scientific evidence informing on specific aspects of the consultation. Using this novel structure, we portray a framework for understanding consultations for persistent musculoskeletal pain from a position of patient-centered research to inform practice.

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“…In daily medical practice, reassurance is defined as the removal of fear and concerns about illness and is considered a core aspect (Traeger et al., 2017). In complex multifactorial conditions, such as LBP, reassurance is particularly important (Jensen & Kongsted, 2021; Traeger et al., 2017), as previous studies report that being able to reassure patients is related to a considerably lower need for subsequent care‐seeking (Braeuninger‐Weimer et al., 2021), greater improvements in patient enablement and satisfaction, and more favourable outcomes, such as fear reduction (Cheung & Soundy, 2021; Simonsen et al., 2021). Reassurance is also important for treatment outcomes in the long term at follow‐up (Pincus, Holt, et al., 2013; Traeger et al., 2017).…”

Section: Introductionmentioning

confidence: 99%

Reassurance regarding educational messages in people with non‐specific low back pain: A cross‐sectional study

Alamam

Alrushud

Alodaibi

et al. 2022

Musculoskeletal Care

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Introduction/Objectives: Educational messages related to Low back pain (LBP) are often contradictory and drive maladaptive beliefs, as they conflict with the latest research evidence. This study aims to examine participants' reassurance levels in relation to educational messages regarding LBP among the Saudi population with the condition compared to those without it, and to assess the association between levels of reassurance and fear avoidance.Methods: A list of 13 educational messages about LBP was generated from LBPeducational resources in Saudi Arabia, and from expert consensus on a set of evidence-based key messages for people with LBP. Consented respondents with LBP of various durations and those without the condition completed a questionnaire containing questions on demographic characteristics, the absence or presence of LBP and its intensity, and the fear-avoidance beliefs questionnaire (FABQ). We also asked them to rate their level of perceived reassurance regarding the educational messages using a Likert-type scale from 0 to 10. Results:Participants (n = 1652) reported that the 13 educational messages had reassured them about LBP. However, there was no significant difference between participants with and without LBP (p ≥ 0.05). There was an overall weak association between the responses to the 13 educational messages and the fear-avoidance questionnaire. However, reassurance levels regarding most of the educational messages were negatively associated with the FABQ. Discussion and conclusion:We demonstrate that people with and without LBP need reassurance about the condition. Furthermore, we show that as reassurance increases, fear-avoidance decreases, confirming the complex nature of LBP.

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Reassuring Patients With Low Back Pain in Primary Care Consultations

Abstract: Supplemental Digital Content is available in the text.

Cited by 5 publications

References 31 publications

A process evaluation of the Mind Your Back trial examining psychologically informed physical treatments for chronic low back pain

A process evaluation of the Mind Your Back trial examining psychologically informed physical treatments for chronic low back pain

Patient-centered consultations for persons with musculoskeletal conditions

Reassurance regarding educational messages in people with non‐specific low back pain: A cross‐sectional study

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