Change in Healthcare Use After a Self-Management Supportive Intervention for Low Back Pain-A Quasi-Experimental Study
Søren Grøn1, Melker Johansson1,2, Kim Rose Olsen3
1Center for Muscle and Joint Health, Departments of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
European Journal of Pain (London, England)
|November 13, 2025
Summary
A structured self-management program for low back pain (LBP) significantly reduced primary care visits and pain reliever use. This intervention shows potential for decreasing healthcare utilization, particularly for those with chronic pain.
Area of Science:
- Musculoskeletal health
- Healthcare utilization research
- Pain management interventions
Background:
- Low back pain (LBP) is associated with high healthcare use (HCU).
- The effectiveness of self-management interventions in reducing HCU for LBP patients remains unclear.
- This study investigated HCU changes following a self-management program for LBP.
Purpose of the Study:
- To assess the impact of a structured self-management program on primary care visits and analgesic redemption in LBP patients.
- To compare healthcare use between patients in a self-management program and those receiving usual care.
- To identify patient subgroups that benefit most from self-management interventions for LBP.
Main Methods:
- Quasi-experimental design involving 4205 adults with LBP in the Danish GLA:D Back program (2018-2022).
- The GLA:D Back program is a 10-week structured intervention combining patient education and supervised exercises.
- Healthcare use data (primary care visits, redeemed analgesic doses) were collected from national registries quarterly.
Main Results:
- A significant reduction in quarterly primary care visits (-1.1) and redeemed analgesic doses (-5.3) was observed post-program enrollment compared to controls.
- Reductions were robust for individuals with LBP duration exceeding one year.
- The most substantial decreases in healthcare use were seen in participants with high baseline healthcare utilization.
Conclusions:
- Structured self-management programs can lead to sustained reductions in primary care visits and analgesic use for LBP patients over three years.
- While regression to the mean may play a role, the findings suggest self-management interventions can effectively alter healthcare use patterns.
- The study highlights the potential of structured self-management support to reduce future healthcare use, especially for individuals with chronic LBP or high initial HCU.
