Self-management of chronic neck and low back pain and relevance of information provided during clinical encounters: an observational study -

Self-management of chronic neck and low back pain and relevance of information provided during clinical encounters: an observational study.
Author(s): Escolar-Reina, P; Medina-Mirapeix, F; Gasc; ón-Cánovas, JJ; Montilla-Herrador, J; Valera-Garrido, JF; Collins, SM
Journal: Arch Phys Med Rehabil 2009 Oct 23; Vol. 90, Issue 10; Page(s) 1734-9

Escolar-Reina P, Medina-Mirapeix F, Gascón-Cánovas JJ, Montilla-Herrador J, Valera-Garrido JF, Collins SM. Self-management of chronic neck and low back pain and relevance of information provided during clinical encounters: an observational study. OBJECTIVE: To assess the relative influence of information provided during physical therapy on a patient's adherence to self-management strategies in relation to other predictors of adherence (patient and pain characteristics, use of self-management strategies before intervention). DESIGN: A longitudinal observational study of the relationship between the information provided during physical therapy and adherence to self-management strategies. SETTING: Data came from a clinical-based population in 8 primary health care centers. PARTICIPANTS: Patients (N=184) with chronic neck or low back pain (77% under the age of 59y) were surveyed at the beginning and 1 month after completion of physical therapy. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Specific and overall adherence to 2 types of strategies: (1) nonpharmacologic pain management strategies, and (2) neck/back care in activities of daily life. RESULTS: Adherence to strategies of nonpharmacologic self-management of pain was more probable when patients received information explaining the effectiveness of the self-management strategies (adjusted odds ratio [AOR]=10.1; P<.05) and information about their illness (AOR=3.4; P<.05) during clinical encounters. Information provided by the physical therapist did not have any influence on the adherence to neck/back care in activity of daily life (P>.05). CONCLUSIONS: Information provided during clinical encounters is associated with adherence to different kinds of self-management strategies. While further study is required, it is suggested that more attention be given to clinical practice strategies for improving adherence to self-management of chronic pain.

Arch Phys Med Rehabil. 2009 Oct;90(10):1734-9.
Email: pescolar@um.es