A multisite longitudinal evaluation of patient characteristics associated with a poor response to non-surgical multidisciplinary management of low back pain in an advanced practice physiotherapist-led tertiary service.

Autor: O'Leary S; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia. s.oleary@uq.edu.au.; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia. s.oleary@uq.edu.au., Raymer M; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia., Window P; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia., Swete Kelly P; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia., Lee D; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia., Garsden L; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia., Tweedy R; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia., Phillips B; Physiotherapy Department, Townsville Hospital, Townsville, Australia., O'Sullivan W; Physiotherapy Department, Townsville Hospital, Townsville, Australia., Wake A; Physiotherapy Department, Townsville Hospital, Townsville, Australia., Smith A; Physiotherapy Department, Cairns Hospital, Cairns, Australia., Pahor S; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Pearce L; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., McLean R; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Thompson D; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Williams E; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Nolan D; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Anning J; Physiotherapy Department, Princess Alexandra Hospital, Brisbane, Australia., Seels I; Physiotherapy Department, Nambour Hospital, Nambour, Australia., Wickins D; Physiotherapy Department, Redcliffe Hospital, Redcliffe, Australia., Marks D; Physiotherapy Department, Gold Coast Hospital, Gold Coast, Australia.; Physiotherapy, Faculty of Health Sciences & Medicine, Bond Institute of Health and Sport, Bond University, Robina, Australia., Diplock B; Physiotherapy Department, Logan Hospital, Logan, Australia., Parravicini V; Physiotherapy Department, Logan Hospital, Logan, Australia., Parnwell L; Physiotherapy Department, Logan Hospital, Logan, Australia., Vicenzino B; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia., Comans T; Centre for Health Services Research, University of Queensland, Brisbane, Australia., Cottrell M; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.; Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia., Khan A; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia., McPhail S; Clinical Informatics Directorate, Metro South Hospital and Health Service, Brisbane, Australia.; Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2020 Dec 03; Vol. 21 (1), pp. 807. Date of Electronic Publication: 2020 Dec 03.
DOI: 10.1186/s12891-020-03839-5
Abstrakt: Background: Non-surgical multidisciplinary management is often the first pathway of care for patients with chronic low back pain (LBP). This study explores if patient characteristics recorded at the initial service examination have an association with a poor response to this pathway of care in an advanced practice physiotherapist-led tertiary service.
Methods: Two hundred and forty nine patients undergoing non-surgical multidisciplinary management for their LBP across 8 tertiary public hospitals in Queensland, Australia participated in this prospective longitudinal study. Generalised linear models (logistic family) examined the relationship between patient characteristics and a poor response at 6 months follow-up using a Global Rating of Change measure.
Results: Overall 79 of the 178 (44%) patients completing the Global Rating of Change measure (28.5% loss to follow-up) reported a poor outcome. Patient characteristics retained in the final model associated with a poor response included lower Formal Education Level (ie did not complete school) (Odds Ratio (OR (95% confidence interval)) (2.67 (1.17-6.09), p = 0.02) and higher self-reported back disability (measured with the Oswestry Disability Index) (OR 1.33 (1.01-1.77) per 10/100 point score increase, p = 0.046).
Conclusions: A low level of formal education and high level of self-reported back disability may be associated with a poor response to non-surgical multidisciplinary management of LBP in tertiary care. Patients with these characteristics may need greater assistance with regard to their comprehension of health information, and judicious monitoring of their response to facilitate timely alternative care if no benefits are attained.
Databáze: MEDLINE
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