Effect of a simple information booklet on pain persistence after an acute episode of low back pain: a non-randomized trial in a primary care setting.
OBJECTIVE
Mass-media campaigns have been known to modify the outcome of low back pain (LBP). We assessed the impact on outcome of standardized written information on LBP given to patients with acute LBP.


METHODS



METHODS
A 3-month pragmatic, multicenter controlled trial with geographic stratification.


METHODS
Primary care practice in France.


METHODS
2752 patients with acute LBP.


METHODS
An advice book on LBP (the "back book").


METHODS
The main outcome measure was persistence of LBP three months after baseline evaluation.


RESULTS
2337 (85%) patients were assessed at follow-up and 12.4% of participants reported persistent LBP. The absolute risk reduction of reporting persistent back pain in the intervention group was 3.6% lower than in the control group (10.5% vs. 14.1%; 95% confidence interval [-6.3% ; -1.0%]; p value adjusted for cluster effect = 0.01). Patients in the intervention group were more satisfied than those in the control group with the information they received about physical activities, when to consult their physician, and how to prevent a new episode of LBP. However, the number of patients who had taken sick leave was similar, as was the mean sick-leave duration, in both arms, and, among patients with persistent pain at follow-up, the intervention and control groups did not differ in disability or fear-avoidance beliefs.


CONCLUSIONS
The level of improvement of an information booklet is modest, but the cost and complexity of the intervention is minimal. Therefore, the implications and generalizability of this intervention are substantial.


BACKGROUND
ClinicalTrials.gov NCT00343057.
Centre de Médecine Physique et Réadaptation Notre Dame, Chamalières, France.
Emmanuel
E
Coudeyre
Florence
F
Tubach
François
F
Rannou
Gabriel
G
Baron
Fernand
F
Coriat
Sylvie
S
Brin
Michel
M
Revel
Serge
S
Poiraudeau
D000328:Adult; D005239:Fear; D005602:France; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010174:Pamphlets; D010353:Patient Education as Topic; D011320:Primary Health Care; D011446:Prospective Studies; D018582:Sick Leave; D011795:Surveys and Questionnaires; D016896:Treatment Outcome