Abstract
Study Design. Low back pain patients seen in primary care were allocated randomly to one of two educational interventions or to usual care. Objective. To evaluate educational interventions designed to improve the outcomes of primary care for low back pain. Summary of Background Data. Patients with back pain are frequently dissatisfied with their medical care and identify lack of information as the most insufficient aspect. Methods. In a large Health Maintenance Organization clinic, 293 subjects were allocated randomly to receive usual care, an educational booklet, or a 15-minute session with a clinic nurse, including the booklet and a follow-up telephone call. Outcome measures included satisfaction with care, perceived knowledge, participation in exercise, functional status, symptom relief, and health care use. Outcomes were assessed 1, 3, 7, and 52 weeks after the intervention. Results. The nurse intervention resulted in higher patient satisfaction than usual care (P <0.001) and higher perceived knowledge (P <0.001). Self-reported exercise participation was also higher in the nurse intervention group after a 1-week follow-up period (97% vs. 65% in the other groups; P <0.0001). There were no significant differences among the three groups in worry, symptoms, functional status, or health care use at any follow-up interval. Differences in self- reported exercise and perceived knowledge were no longer significant after 7 weeks. Conclusions. These findings challenge the value of purely educational approaches in reducing functional impact or health care use related to back pain and also challenge the value of fitness exercise in the most acute phase of back pain.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 345-355 |
| Number of pages | 11 |
| Journal | Spine |
| Volume | 21 |
| Issue number | 3 |
| DOIs | |
| State | Published - Feb 1 1996 |
| Externally published | Yes |
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Keywords
- back pain
- education
- effectiveness
- exercise
- nurse
- primary care
ASJC Scopus subject areas
- Physiology
- Clinical Neurology
- Orthopedics and Sports Medicine
Cite this
Pitfalls of patient education : Limited success of a program for back pain in primary care. / Cherkin, Daniel C.; Deyo, Richard (Rick); Street, Janet H.; Hunt, Marcia; Barlow, William.
In: Spine, Vol. 21, No. 3, 01.02.1996, p. 345-355.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pitfalls of patient education
T2 - Limited success of a program for back pain in primary care
AU - Cherkin, Daniel C.
AU - Deyo, Richard (Rick)
AU - Street, Janet H.
AU - Hunt, Marcia
AU - Barlow, William
PY - 1996/2/1
Y1 - 1996/2/1
N2 - Study Design. Low back pain patients seen in primary care were allocated randomly to one of two educational interventions or to usual care. Objective. To evaluate educational interventions designed to improve the outcomes of primary care for low back pain. Summary of Background Data. Patients with back pain are frequently dissatisfied with their medical care and identify lack of information as the most insufficient aspect. Methods. In a large Health Maintenance Organization clinic, 293 subjects were allocated randomly to receive usual care, an educational booklet, or a 15-minute session with a clinic nurse, including the booklet and a follow-up telephone call. Outcome measures included satisfaction with care, perceived knowledge, participation in exercise, functional status, symptom relief, and health care use. Outcomes were assessed 1, 3, 7, and 52 weeks after the intervention. Results. The nurse intervention resulted in higher patient satisfaction than usual care (P <0.001) and higher perceived knowledge (P <0.001). Self-reported exercise participation was also higher in the nurse intervention group after a 1-week follow-up period (97% vs. 65% in the other groups; P <0.0001). There were no significant differences among the three groups in worry, symptoms, functional status, or health care use at any follow-up interval. Differences in self- reported exercise and perceived knowledge were no longer significant after 7 weeks. Conclusions. These findings challenge the value of purely educational approaches in reducing functional impact or health care use related to back pain and also challenge the value of fitness exercise in the most acute phase of back pain.
AB - Study Design. Low back pain patients seen in primary care were allocated randomly to one of two educational interventions or to usual care. Objective. To evaluate educational interventions designed to improve the outcomes of primary care for low back pain. Summary of Background Data. Patients with back pain are frequently dissatisfied with their medical care and identify lack of information as the most insufficient aspect. Methods. In a large Health Maintenance Organization clinic, 293 subjects were allocated randomly to receive usual care, an educational booklet, or a 15-minute session with a clinic nurse, including the booklet and a follow-up telephone call. Outcome measures included satisfaction with care, perceived knowledge, participation in exercise, functional status, symptom relief, and health care use. Outcomes were assessed 1, 3, 7, and 52 weeks after the intervention. Results. The nurse intervention resulted in higher patient satisfaction than usual care (P <0.001) and higher perceived knowledge (P <0.001). Self-reported exercise participation was also higher in the nurse intervention group after a 1-week follow-up period (97% vs. 65% in the other groups; P <0.0001). There were no significant differences among the three groups in worry, symptoms, functional status, or health care use at any follow-up interval. Differences in self- reported exercise and perceived knowledge were no longer significant after 7 weeks. Conclusions. These findings challenge the value of purely educational approaches in reducing functional impact or health care use related to back pain and also challenge the value of fitness exercise in the most acute phase of back pain.
KW - back pain
KW - education
KW - effectiveness
KW - exercise
KW - nurse
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=0030064997&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030064997&partnerID=8YFLogxK
U2 - 10.1097/00007632-199602010-00019
DO - 10.1097/00007632-199602010-00019
M3 - Article
VL - 21
SP - 345
EP - 355
JO - Spine
JF - Spine
SN - 0362-2436
IS - 3
ER -