title: Translating evidence for low back pain management into a consumer-focussed resource for use in community pharmacies: a cluster-randomised controlled trial.
abstract: BACKGROUND
  This cluster-randomised controlled trial determined the effectiveness of an evidence-based, pamphlet intervention in improving low back pain (LBP)-related beliefs among pharmacy consumers.
  
  
  METHODS
  THIRTY FIVE COMMUNITY PHARMACIES WERE RANDOMISED TO THREE GROUPS: pamphlet+education intervention [n = 11]; pamphlet only intervention [n = 11]; control: usual care [n = 13]. Eligibility requirements for clusters included: community-based pharmacies and proprietor participation consent. Pharmacy consumers (N = 317) aged 18-65 years currently experiencing LBP participated. Intervention group allocation depended on the pharmacy attended. Individual-level outcomes were measured at pre-intervention (T0), at two (T1) and eight (T2) weeks post-intervention and included beliefs about LBP [Back Pain Beliefs Questionnaire (BBQ); Fear Avoidance Beliefs Questionnaire (FABQ)]. Secondary outcomes included pain severity, activity impairment and pamphlet perceived usefulness. Blinding to group allocation included primary investigators, outcome assessors and the statistician. Pharmacy staff and consumers were un-blinded.
  
  
  RESULTS
  Of 35 pharmacies recruited (317 consumers), no clusters were lost to follow-up. Follow-up was available for n = 24 at 2 weeks only; n = 38 at 8 weeks only; n = 148 at both time points, with n = 148+24+38 = 210 analysed (107 excluded: no follow up). Adjusting for baseline scores demonstrated no significant differences in beliefs (2 or at 8 weeks) between pamphlet (with or without education) versus control, or between 'pamphlet with' versus 'without' education. Work-related fear (FABQ) was significantly lower in consumers receiving pamphlet (with or without education) versus control (difference -2.3, 95%CI: -4.4 to -0.2). There was no significant difference between "pamphlet with" versus "pamphlet without" groups. Consumers receiving the "pamphlet with" reported greater perceived usefulness than consumers receiving the "pamphlet without" (difference 0.9 (95%CI: 0.0 to 1.8)).
  
  
  CONCLUSIONS
  Community pharmacies provided a feasible primary care portal for implementing evidence-based information. The associated improvement in work-related LBP-beliefs for consumers receiving the pamphlet suggests this simple intervention may be a useful component of care.
  
  
  BACKGROUND
  ACTR.org.au ACTRN12611000053921.
authors: School of Physiotherapy, Curtin University, Perth, Western Australia, Australia ; Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
authors: Helen
authors: H
authors: Slater
authors: Andrew M
authors: AM
authors: Briggs
authors: Kim
authors: K
authors: Watkins
authors: Jason
authors: J
authors: Chua
authors: Anne J
authors: AJ
authors: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D054626:Consumer Health Information; D019317:Evidence-Based Medicine; D005239:Fear; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010353:Patient Education as Topic; D063868:Patient Outcome Assessment; D010594:Pharmacies; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D055815:Young Adult
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