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'Reassurance and healthcare seeking in people with persistent musculoskeletal low back pain consulting orthopaedic spine practitioners: A prospective cohort study'
Author(s) -
BraeuningerWeimer Kathrin,
Rooslien Hanna,
Anjarwalla Naffis,
Pincus Tamar
Publication year - 2021
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1765
Subject(s) - medicine , distress , physical therapy , back pain , health care , low back pain , emotional distress , cohort , pain catastrophizing , perception , prospective cohort study , cohort study , health professionals , family medicine , alternative medicine , anxiety , psychiatry , chronic pain , psychology , clinical psychology , pathology , neuroscience , economics , economic growth
Background Guidelines recommend self‐management for most people living with persistent musculoskeletal low back pain (PMLBP) when surgery is ruled out. Conveying this message to patients can be challenging. This study examined patients' perceptions of reassuring communications from surgical spine team practitioners attempting to deliver this message in a single consultation. Methods Pre‐consultation baseline measures included levels of pain, disability and previous consultation history. Patients' perceptions of reassuring communications were measured within 1‐week post‐consultation. The outcome variables, measured at 3‐month follow‐up, included patients’ report of subsequent GP visits for back pain, the number of other healthcare providers consulted for back pain and distress. Results Data from 296 patients (9.8% loss to follow‐up) were analysed using hierarchical regression models, controlling for demographic, clinical and study‐related factors. In each model, perceived reassurance accounted for a small but significant variance, above and beyond other predictors. Further GP visits were predicted by disability at baseline and perceived reassurance (adjusted R 2 of 14.6%). Subsequent consultations with any healthcare professionals were predicted by a shorter duration of back pain, disability at baseline and perceived reassurance (adj. R 2 = 10.6%). Distress was predicted by older age, disability and reassurance (adj. R 2 = 59.5%). Conclusion Findings suggest that better communication in consultations with orthopaedic spine clinicians might help reduce unnecessary subsequent healthcare utilization and distress. Significance Low back pain patients' perceptions of their communication with orthopaedic spine practitioners are associated with subsequent healthcare seeking and distress at follow‐up. This study examines the intersection of two important but fairly neglected areas in the pain research: provider communication and patient healthcare utilization.