Assessing patient education materials about low back pain for understandability, actionability, quality, readability,...

Patients have unhelpful beliefs about low back pain (LBP), which are associated with worse outcomes. Education may modify these beliefs, but patients with LBP rarely receive education in practice. Patient education materials (PEMs) are a quick, inexpensive intervention to support information provision.

assess PEMs for understandability, actionability, quality, readability, accuracy, comprehensiveness, and coverage of information about patients' needs to identify the best PEMs for practice.

We searched published literature for PEMs tested in randomized trials or recommended in clinical guidelines. We used the Patient Education Materials Assessment Tool (PEMAT) to assess understandability and actionability, DISCERN to assess quality, the Patient Information and Education Needs Checklist for Low Back Pain (PINE-LBP) to assess information need coverage, and the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade-Level (FKGL) algorithms to assess readability. We assessed accuracy (proportion of treatment recommendations aligning with guidelines) and comprehensiveness (proportion of correctly covered guideline recommendations), and qualitatively synthesized PEM content relating to 21 information and education needs about LBP.

Nineteen PEMs were included. None were actionable or comprehensive, and many had inaccurate treatment recommendations. There was considerable variation and conflicting information in the content provided across PEMs. Only the My Back Pain website met acceptable standards for more than half (4/7) outcomes.

Educational messaging for LBP varies substantially and PEMs require improvement in various areas. The My Back Pain website met acceptable standards across most outcomes and may be the best available option for practice.