Education of patients after whiplash injury: is oral advice any better than a pamphlet?
METHODS
Randomized parallel-group trial with 1-year follow-up.


OBJECTIVE
To evaluate whether education of patients communicated orally by a specially trained nurse is superior to giving patients a pamphlet after a whiplash injury.


BACKGROUND
Long-lasting pain and physical disability after whiplash injuries are related to both serious personal suffering and huge socio-economic costs. Pure educational interventions after such injuries seem generally as effective as more costly interventions, but it is unknown if the way advice is communicated is of any importance.


METHODS
Participants with relatively mild complaints after car collisions were recruited from emergency departments and GPs. A total of 182 participants were randomized to either: (1) a 1 hour-educational session with a specially trained nurse, or (2) an educational pamphlet. Outcome parameters were neck pain, headache, disability, and return to work. Recovery was defined as scoring pain 0 or 1 (0-10 point scale) and not being off sick at the time of the follow-ups.


RESULTS
After 3, 6, and 12 months 60%, 58%, and 66%, respectively of the participants had recovered. Group differences were nonsignificant on all outcome parameters, even though the outcome tended to be better for the group receiving personal advice.


CONCLUSIONS
Prognosis did not differ between patients who received personal education and those who got a pamphlet. However, a systematic tendency toward better outcome with personal communicated information was observed and the question how patients should be educated to reduce the risk of chronicity after whiplash is worth further investigation, since no treatment have been proven to prevent long-lasting symptoms, and all forms of advice or educational therapy are so cheap that even a modest effect justifies its use.
Kongsted
Alice
A
The Back Research Center Part of Clinical Locomotion Science, Backcenter Funen, University of Southern Denmark, Ringe, Denmark. a.kongsted@nikkb.dk
Qerama
Erisela
E
Kasch
Helge
H
Bach
Flemming Winther
FW
Korsholm
Lars
L
Jensen
Troels Staehelin
TS
Bendix
Tom
T
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D003376:Counseling; D003718:Denmark; D004185:Disability Evaluation; D005260:Female; D006261:Headache / Q000209:etiology / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000628:therapy; D009723:Nurse-Patient Relations; D010174:Pamphlets; D010353:Patient Education as Topic; D011446:Prospective Studies; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014911:Whiplash Injuries / Q000150:complications / Q000451:nursing / Q000628:therapy*; D055815:Young Adult