Attributes Underlying Non-surgical Treatment Choice for People With Low Back Pain: A Systematic Mixed Studies Review

Document Type: Review Article

Authors

1 School of Public Health, University of Montreal, Montreal, QC, Canada

2 Research Center of the IUSMM, CIUSSS de l’Est de l’Île de Montréal, Montreal, QC, Canada

3 CERDI, Université Clermont Auvergne, ClermontFerrand, France

Abstract

Background
The knowledge of patients’ preferences in the medical decision-making process is gaining in importance. In this article we aimed to provide an overview on the importance of attributes underlying the choice of non-surgical treatments in people with low back pain (LBP).

 
Methods
A systematic mixed studies review was conducted. Articles were retrieved from the search engines PubMed, ScienceDirect, and Scopus through June 21, 2018. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the study, and each step was performed by 2 reviewers.

 
Analysis
From a total of 390 articles, 13 were included in the systematic review, all of which were considered to be of good quality. Up to 40 attributes were found in studies using various methods. Effectiveness, ie, pain reduction, was the most important attribute considered by patients in their choice of treatment. This attribute was cited by 7 studies and was systematically ranked first or second in each. Other important attributes included the capacity to realize daily life activities, fit to patient’s life, and the credibility of the treatment, among others.

 
Discussion
Pain reduction was the most important attribute underlying patients’ choice for treatment. However, this was not the only trait, and future research is needed to determine the relative importance of the attributes.

Highlights

Supplementary File 1 (Download)

Keywords


  1. Schmidt CO, Raspe H, Pfingsten M, et al. Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine (Phila Pa 1976). 2007;32(18):2005-2011. doi:10.1097/BRS.0b013e318133fad8
  2. Cassidy JD, Carroll LJ, Côté P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998;23(17):1860-1866. doi:10.1097/00007632-199809010-00012
  3. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-2367. doi:10.1016/s0140-6736(18)30480-x
  4. National Institute of Neurological Disorders and Stroke. Low Back Pain Fact Sheet. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet.
  5. World Health Organization (WHO). Priority Medicines for Europe and the World. WHO; 2013.
  6. Fayad F, Lefevre-Colau MM, Poiraudeau S, et al. Chronicity, recurrence, and return to work in low back pain: common prognostic factors. Ann Readapt Med Phys. 2004;47(4):179-189. doi:10.1016/j.annrmp.2004.01.005
  7. Poiraudeau S, Lefevre-Colau MM, Fayad F, et al. Low back pain. EMC Rhumatol Orthop. 2004;1:295-319.
  8. Véron O, Tcherniatinsky E, Fayad F, Revel M, Poiraudeau S. Chronic low back pain and functional restoring program: applicability of the Patient Acceptable Symptom State. Ann Readapt Med Phys. 2008;51(8):642-649. doi:10.1016/j.annrmp.2008.08.003
  9. Waddell G. Simple low back pain: rest or active exercise? Ann Rheum Dis. 1993;52(5):317-319. doi:10.1136/ard.52.5.317
  10. Náfrádi L, Nakamoto K, Schulz PJ. Is patient empowerment the key to promote adherence? a systematic review of the relationship between self-efficacy, health locus of control and medication adherence. PLoS One. 2017;12(10):e0186458. doi:10.1371/journal.pone.0186458
  11. Bowling A, Ebrahim S. Measuring patients' preferences for treatment and perceptions of risk. Qual Health Care. 2001;10 Suppl 1:i2-8.
  12. Haldeman S, Dagenais S. A supermarket approach to the evidence-informed management of chronic low back pain. Spine J. 2008;8(1):1-7. doi:10.1016/j.spinee.2007.10.009
  13. Balagué F, Dudler J. An overview of conservative treatment for lower back pain. Int J Clin Rheumtol. 2011;6(3):281-290.
  14. Aboagye E. Valuing individuals’ preferences and health choices of physical exercise. Pain Ther. 2017;6(1):85-91. doi:10.1007/s40122-017-0067-4
  15. Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron LD, Leventhal H, eds. The Self-Regulation of Health and Illness Behaviour. Routledge; 2003:42-65.
  16. The National Institute for Health and Care Excellence (NICE). Low Back Pain and Sciatica in Over 16s: Assessment and Management. London: NICE; 2016.
  17. Institut national d’excellence en santé et en services sociaux (INESSS). Les normes de production des revues systématiques. Guide méthodologique. Montréal: INESSS; 2013:44.
  18. Pluye P, Robert E, Cargo M, et al. Proposal: A Mixed Methods Appraisal Tool for Systematic Mixed Studies Reviews. Montreal: McGill Univ; 2011:1-8.
  19. Beinart NA, Goodchild CE, Weinman JA, Ayis S, Godfrey EL. Individual and intervention-related factors associated with adherence to home exercise in chronic low back pain: a systematic review. Spine J. 2013;13(12):1940-1950. doi:10.1016/j.spinee.2013.08.027
  20. Finch AP, Dritsaki M, Jommi C. Generic preference-based measures for low back pain: which of them should be used? Spine (Phila Pa 1976). 2016;41(6):E364-374. doi:10.1097/brs.0000000000001247
  21. Slade SC, Patel S, Underwood M, Keating JL. What are patient beliefs and perceptions about exercise for nonspecific chronic low back pain? a systematic review of qualitative studies. Clin J Pain. 2014;30(11):995-1005. doi:10.1097/ajp.0000000000000044
  22. Bishop MD, Bialosky JE, Penza CW, Beneciuk JM, Alappattu MJ. The influence of clinical equipoise and patient preferences on outcomes of conservative manual interventions for spinal pain: an experimental study. J Pain Res. 2017;10:965-972. doi:10.2147/jpr.s130931
  23. NICE guidelines for low-back pain. J Natl Med Assoc. 2009;101:974. doi:10.1016/S0027-9684(15)31051-8
  24. George SZ, Robinson ME. Preference, expectation, and satisfaction in a clinical trial of behavioral interventions for acute and sub-acute low back pain. J Pain. 2010;11(11):1074-1082. doi:10.1016/j.jpain.2010.02.016
  25. Arefyev A, Lechauve JB, Gay C, et al. Mobile application development through qualitative research in education program for chronic low back patients. Ann Phys Rehabil Med. 2017;60:e102-e103. doi:10.1016/j.rehab.2017.07.070
  26. Perrot S, Concas V, Allaert F, Laroche F. Deciding on analgesic prescription dosing for acute back pain: once daily or more? Presse Med. 2008;37(1 Pt 1):14-20. doi:10.1016/j.lpm.2007.09.011
  27. Blanchette MA, Rivard M, Dionne CE, Hogg-Johnson S, Steenstra I. Workers' characteristics associated with the type of healthcare provider first seen for occupational back pain. BMC Musculoskelet Disord. 2016;17(1):428. doi:10.1186/s12891-016-1298-y
  28. Cooper K, Smith BH, Hancock E. Patients' perceptions of self-management of chronic low back pain: evidence for enhancing patient education and support. Physiotherapy. 2009;95(1):43-50. doi:10.1016/j.physio.2008.08.005
  29. Lynch AD, Bove AM, Ammendolia C, Schneider M. Individuals with lumbar spinal stenosis seek education and care focused on self-management-results of focus groups among participants enrolled in a randomized controlled trial. Spine J. 2018;18(8):1303-1312. doi:10.1016/j.spinee.2017.11.019
  30. Pauwels C, Roren A, Gautier A, et al. Home-based cycling program tailored to older people with lumbar spinal stenosis: barriers and facilitators. Ann Phys Rehabil Med. 2018;61(3):144-150. doi:10.1016/j.rehab.2018.02.005
  31. Zandwijk P, van Koppen B, van Mameren H, Winkens B, de Bie R. Physical activity preferences of patients experiencing non-specific low back pain. Eur J Physiother. 2018;20(1):51-57. doi:10.1080/21679169.2017.1357753
  32. Liddle SD, Baxter GD, Gracey JH. Chronic low back pain: patients' experiences, opinions and expectations for clinical management. Disabil Rehabil. 2007;29(24):1899-1909. doi:10.1080/09638280701189895
  33. Iles RA, Taylor NF, Davidson M, O'Halloran PD. Patient recovery expectations in non-chronic non-specific low back pain: a qualitative investigation. J Rehabil Med. 2012;44(9):781-787. doi:10.2340/16501977-1019
  34. Bishop MD, Bialosky JE, Cleland JA. Patient expectations of benefit from common interventions for low back pain and effects on outcome: secondary analysis of a clinical trial of manual therapy interventions. J Man Manip Ther. 2011;19(1):20-25. doi:10.1179/106698110x12804993426929
  35. Maiers M, Hondras MA, Salsbury SA, Bronfort G, Evans R. What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial. Man Ther. 2016;26:183-191. doi:10.1016/j.math.2016.09.008
  36. Takeda O, Chiba D, Ishibashi Y, Tsuda E. Patient-physician differences in desired characteristics of NSAID plasters: an online survey. Pain Res Manag. 2017;2017:5787854. doi:10.1155/2017/5787854
  37. Chancellor J, Martin M, Liedgens H, Baker MG, Müller-Schwefe GH. Stated preferences of physicians and chronic pain sufferers in the use of classic strong opioids. Value Health. 2012;15(1):106-117. doi:10.1016/j.jval.2011.07.002
  38. Bethge M. [Patient preferences and willingness to wait for a work-related orthopaedic rehabilitation: a discrete choice experiment]. Gesundheitswesen. 2009;71(3):152-160. doi:10.1055/s-0028-1124109
  39. Kløjgaard ME, Hess S. Understanding the formation and influence of attitudes in patients' treatment choices for lower back pain: testing the benefits of a hybrid choice model approach. Soc Sci Med. 2014;114:138-150. doi:10.1016/j.socscimed.2014.05.058
  40. Slade SC, Keating JL. Effects of preferred-exercise prescription compared to usual exercise prescription on outcomes for people with non-specific low back pain: a randomized controlled trial [ACTRN12608000524392]. BMC Musculoskelet Disord. 2009;10:14. doi:10.1186/1471-2474-10-14
  41. Francois SJ, Lanier VM, Marich AV, Wallendorf M, Van Dillen LR. A cross-sectional study assessing treatment preference of people with chronic low back pain. Arch Phys Med Rehabil. 2018;99(12):2496-2503. doi:10.1016/j.apmr.2018.04.027
  42. Aboagye E, Hagberg J, Axén I, et al. Individual preferences for physical exercise as secondary prevention for non-specific low back pain: A discrete choice experiment. PLoS One. 2017;12(12):e0187709. doi:10.1371/journal.pone.0187709
  43. Yi D, Ryan M, Campbell S, et al. Using discrete choice experiments to inform randomised controlled trials: an application to chronic low back pain management in primary care. Eur J Pain. 2011;15(5):531.e531-510. doi:10.1016/j.ejpain.2010.10.008
  44. Hsu C, Bluespruce J, Sherman K, Cherkin D. Unanticipated benefits of CAM therapies for back pain: an exploration of patient experiences. J Altern Complement Med. 2010;16(2):157-163. doi:10.1089/acm.2009.0188
  45. Slade SC, Molloy E, Keating JL. People with non-specific chronic low back pain who have participated in exercise programs have preferences about exercise: a qualitative study. Aust J Physiother. 2009;55(2):115-121. doi:10.1016/s0004-9514(09)70041-8
  46. Verbrugghe J, Haesen M, Spierings R, et al. Skill training preferences and technology use in persons with neck and low back pain. Disabil Rehabil Assist Technol. 2017;12(8):801-807. doi:10.1080/17483107.2016.1269208
  47. Chen LC, Cheng LJ, Zhang Y, He X, Knaggs RD. Acupuncture or low frequency infrared treatment for low back pain in Chinese patients: a discrete choice experiment. PLoS One. 2015;10(5):e0126912. doi:10.1371/journal.pone.0126912
  48. Dima A, Lewith GT, Little P, et al. Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care. Pain. 2015;156(8):1489-1500. doi:10.1097/j.pain.0000000000000193
  49. Gardner T, Refshauge K, McAuley J, Goodall S, Hübscher M, Smith L. Patient led goal setting in chronic low back pain-What goals are important to the patient and are they aligned to what we measure? Patient Educ Couns. 2015;98(8):1035-1038. doi:10.1016/j.pec.2015.04.012
  50. Kløjgaard ME, Manniche C, Pedersen LB, Bech M, Søgaard R. Patient preferences for treatment of low back pain-a discrete choice experiment. Value Health. 2014;17(4):390-396. doi:10.1016/j.jval.2014.01.005
  51. Dima A, Lewith GT, Little P, Moss-Morris R, Foster NE, Bishop FL. Identifying patients' beliefs about treatments for chronic low back pain in primary care: a focus group study. Br J Gen Pract. 2013;63(612):e490-498. doi:10.3399/bjgp13X669211
  52. Haanstra TM, Hanson L, Evans R, et al. How do low back pain patients conceptualize their expectations regarding treatment? content analysis of interviews. Eur Spine J. 2013;22(9):1986-1995. doi:10.1007/s00586-013-2803-8
  53. Kløjgaard ME, Bech M, Søgaard R. Designing a stated choice experiment: the value of a qualitative process. J Choice Model. 2012;5(2):1-18. doi:10.1016/S1755-5345(13)70050-2
  54. Bowling A, Rowe G, Lambert N, et al. The measurement of patients' expectations for health care: a review and psychometric testing of a measure of patients' expectations. Health Technol Assess. 2012;16(30):i-xii, 1-509. doi:10.3310/hta16300
  55. Poder TG. Editorial: better understanding health preferences. Int J Health Prefer Res. 2016;1:1. doi:10.21965/IJHPR.2016.E
  56. Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you'll do? a systematic review of the evidence for a relation between patients' recovery expectations and health outcomes. CMAJ. 2001;165(2):174-179.
  57. Strull WM, Lo B, Charles G. Do patients want to participate in medical decision making? JAMA. 1984;252(21):2990-2994.
  58. Main CJ, Foster N, Buchbinder R. How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Pract Res Clin Rheumatol. 2010;24(2):205-217. doi:10.1016/j.berh.2009.12.012
  59. Greene SM, Tuzzio L, Cherkin D. A framework for making patient-centered care front and center. Perm J. 2012;16(3):49-53.
  60. Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361-1367. doi:10.1007/s11606-012-2077-6