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Titolo:
Should we give detailed advice and information booklets to patients with back pain? A randomized controlled factorial trial of a self-management booklet and doctor advice to take exercise for back pain
Autore:
Little, P; Roberts, L; Blowers, H; Garwood, J; Cantrell, T; Langridge, J; Chapman, J;
Indirizzi:
Univ Southampton, Primary Med Care Grp, Aldermoor Hlth Ctr, Southampton SO16 5ST, Hants, England Univ Southampton Southampton Hants England SO16 5ST6 5ST, Hants, England Univ Southampton, Sch Hlth Profess & Rehabil Sci, Southampton SO16 5ST, Hants, England Univ Southampton Southampton Hants England SO16 5ST 6 5ST, Hants, England Southampton Univ Hosp Trust, Dept Rheumatol, Southampton, Hants, England Southampton Univ Hosp Trust Southampton Hants England on, Hants, England Southampton Univ Hosp Trust, Physiotherapy Dept, Southampton, Hants, England Southampton Univ Hosp Trust Southampton Hants England on, Hants, England
Titolo Testata:
SPINE
fascicolo: 19, volume: 26, anno: 2001,
pagine: 2065 - 2072
SICI:
0362-2436(20011001)26:19<2065:SWGDAA>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
EDUCATIONAL BOOKLET; GENERAL-PRACTICE; PRESCRIBING STRATEGIES; PRIMARY-CARE; SORE THROAT; BED REST; THERAPY; PROGRAM;
Keywords:
low back pain; information booklets; exercise; primary care;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Little, P Univ Southampton, Primary Med Care Grp, Aldermoor Hlth Ctr, Aldermoor Close, Southampton SO16 5ST, Hants, England Univ Southampton Aldermoor Close Southampton Hants England SO16 5ST
Citazione:
P. Little et al., "Should we give detailed advice and information booklets to patients with back pain? A randomized controlled factorial trial of a self-management booklet and doctor advice to take exercise for back pain", SPINE, 26(19), 2001, pp. 2065-2072

Abstract

Study Design. Randomized controlled factorial trial. Objective. To assess the effectiveness of a booklet and of physician advice to take regular exercise. Summary of Background Data. Educational booklets are one of the simplest interventions for back pain but have not been shown to alter pain and function. Although there is evidence that advice to mobilize is effective, doctors have also been advised to encourage regular exercise-but there is no evidence that such advice alone improves outcomes. Method. Eight doctors from six practices randomized 311 patients with a new episode of back pain using sealed numbered opaque envelopes to receive a detailed selfmanagement booklet, advice to take regular exercise, both, or neither. All groups were advised to mobilize and to use simple analgesia. Patients were telephoned during the first week after entry into the study, and after 3 weeks to assess a validated numerical pain/function score (0 = no pain normal activities to 100 = extreme pain no normal activities). Patients also returned a postal questionnaire in the first week with the Aberdeen pain and function scale, a knowledge score, and a reliable satisfaction scale (mean score of 4 items: 0 = not satisfied to 100 = extremely satisfied). Results. Pain/function scores were obtained in 239 (77%) patients. There were interactions between exercise and booklet groups for both pain/functionscores and the Aberdeen scale, which are unlikely to have been chance findings (P = 0.009 and P = 0.012, respectively). In comparison with the control group, there were reductions in the pain/function score in the first weekwith a booklet (-8.7, 95% CI -17.4 to -0.03) or advice to exercise (-7.9; -16.7 to 0.8) but much less effect with both together (-0.08, -9.0 to 8.9). Similarly, the Aberdeen scale was lower in the booklet group (-3.8, -7.7 to 0.07) and in the exercise advice group (-5.3; -9.3 to -1.38) but much less with both combined (-1.9, -5.8 to 2.1). There was no scores by week 3, when 58% reported being back to normal. Satisfaction was increased in booklet(7.9, 1.3 to 14.4) and exercise groups (7.4, 0.8 to 13.9)), and a booklet also increased knowledge (Kruskal-Wallis chi (2) 27.2, P = 0.001). Conclusion. Doctors can increase satisfaction and moderately improve functional outcomes in the period immediately after the consultation when back pain is worst, by using very simple interventions: either by endorsing a self-management booklet or by giving advice to take exercise. Previous studiessuggest that simple advice and the same written information provide reinforcement. This study supports evidence that it may not be helpful to providea detailed information booklet and advice together, where the amounts or formats of information differ.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 00:01:27