Randomized trial of a self-management program for primary care patients with acute low back pain: short-term effects.
OBJECTIVE
We evaluated the effect of a self-management program (SMP) on primary care patients with acute low back pain (ALBP) from low income, inner city neighborhood health centers and an emergency department of a public teaching hospital.


METHODS
We randomized 211 primary care patients who visited a physician for ALBP (<90 days duration) to usual care or an SMP. The SMP consisted of 3 group sessions and telephone followup that focused on understanding back pain, increasing physical activity, and dealing with fears and frustrations.


RESULTS
Of the eligible patients, 52% expressed interest in participation and 39% of all eligible patients were randomized into the study. Among patients in the treatment group, 28.3% attended at least 1 group class, 62.3% received the intervention by mail, telephone, and audiotapes, and 9.4% received no intervention. Interviewers, blinded to the treatment given, collected data at baseline and at 4 months following randomization. Compared with the control group, the intervention group reported significantly better emotional functioning (P < 0.01), increased self efficacy to manage ALBP (P = 0.03), and less fear of movement (P = 0.05) after 4 months.


CONCLUSIONS
This SMP produced short-term improvements in emotional functioning and self efficacy to manage symptoms among patients with ALBP living in the inner city. However, methods of program delivery other than group classes are needed to reach a greater portion of the inner city patients.
Damush
Teresa M
TM
Indiana University Center for Aging Research, Regenstrief Institute, Inc and Indiana University School of Medicine, Indianapolis 46202-2872, USA. tdamush@regenstrief.org
Weinberger
Morris
M
Perkins
Susan M
SM
Rao
Jaya K
JK
Tierney
William M
WM
Qi
Rong
R
Clark
Daniel O
DO
D000203:Activities of Daily Living; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration*; D015397:Program Evaluation; D012648:Self Care; D020377:Self Efficacy; D016896:Treatment Outcome; D014505:Urban Population