Information and low back pain management: a systematic review

Area of Science:

• Evidence-based practice
• Health services research
• Rehabilitation medicine

Background:

• Information provision is a common primary care strategy for low back pain.
• Booklets are the most frequent format for delivering patient information.
• The effectiveness of different information types requires systematic evaluation.

Purpose of the Study:

• To evaluate the efficacy of information as a preventive measure and/or therapy for low back pain.
• To identify the most effective types of information for managing low back pain.
• To assess the impact of information on patient knowledge, beliefs, and health outcomes.

Main Methods:

• Systematic literature search of Medline, PsyclInfo, and Embase databases.
• Inclusion of randomized controlled trials (RCTs) and other study designs.
• Evidence strength assessment based on methodological quality, outcome relevance, and result consistency.

Main Results:

• Seven high-quality RCTs showed mixed results; only three demonstrated favorable outcomes for information.
• Strong evidence supports booklets increasing knowledge and physician cues enhancing adherence.
• Limited evidence suggests biopsychosocial booklets may shift beliefs more effectively than biomedical ones.
• Booklets show no efficiency in reducing absenteeism and conflicting evidence for healthcare use reduction.
• Email or video programs alone lack evidence for reducing low back pain, disability, or costs.

Conclusions:

• Information grounded in a biopsychosocial model is recommended for primary care to modify patient beliefs about low back pain.
• Information delivery alone is insufficient for preventing absenteeism or decreasing healthcare expenditures.
• Further research may be needed to optimize information strategies for low back pain management.