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Patient and clinician treatment preferences do not moderate the effect of exercise treatment in chronic whiplash‐associated disorders
Author(s) -
Stewart Mark J.,
Maher Chris G.,
Refshauge Kathryn M.,
Herbert Rob D.,
Nicholas Michael K.
Publication year - 2008
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 - 10.1016/j.ejpain.2007.12.009
Subject(s) - whiplash , physical therapy , medicine , randomized controlled trial , randomization , chronic pain , preference , treatment and control groups , visual analogue scale , treatment effect , poison control , microeconomics , environmental health , economics , traditional medicine
An issue that arises when selecting therapy is whether patient or clinician preferences for treatment moderate the effect of treatment. To evaluate this question we conducted a secondary analysis of the results of a randomized controlled trial of exercise treatment of chronic whiplash. Immediately prior to randomization, treatment preference ratings were collected from each patient and from the physiotherapist who assessed each patient. Patients were then randomized to receive advice alone or exercise and advice with the primary treatment outcomes of pain and function measured immediately after conclusion of treatment. Treatment effect modification was evaluated with a treatment group by preference interaction term in the regression analyses. The analysis revealed that neither patient nor therapist treatment preferences moderated the effect of exercise treatment for chronic whiplash. The interaction effect of treatment group by patient preference was 0.1 (−0.3 to 0.5, p =0.68) on the 0–10 pain intensity scale and −0.1 (−0.5 to 0.3, p =0.64) on the 0–10 function scale. The interaction effect of treatment group by therapist preference was 0.0 (−0.3 to 0.4, p =0.786) on the 0–10 pain intensity scale and −0.2 (−0.4 to 0.1, p =0.296) on the 0–10 function scale. Our findings do not provide evidence that patient or therapist treatment preferences moderate the effect of exercise treatment for chronic whiplash.