SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2008
Content and outcome of usual primary care for back pain: a systematic review.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01981798 (The Long-term Effect of an Outpatient Intervention Program With a Behavioral Therapy Approach in Patients With Chronic Back or Neck Pain With a Focus on Psychosocial Aspects), which is not on this map. Cited by 36 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Long-term Effect of an Outpatient Intervention Program With a Behavioral Therapy Approach in Patients With Chronic Back or Neck Pain With a Focus on Psychosocial Aspects
Who cites it
36 citing papers in PubMed, 5 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Reporting Completeness of Usual Care Comparator Groups in Exercise-Based Trials for Knee Osteoarthritis: A Meta-Research Systematic Review.Musculoskeletal care · 2026Pooled it
- Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines.European journal of pain (London, England) · 2021Pooled it
- Lumbar Spine X-Ray as a Standard Investigation for all Low back Pain in Ghana: Is It Evidence Based?Ghana medical journal · 2017Pooled it
- Psychological therapies for the management of chronic pain (excluding headache) in adults.The Cochrane database of systematic reviews · 2012Pooled it
- Psychological treatment of depression in primary care: a meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Pooled it
- Stratified primary care versus non-stratified care for musculoskeletal pain: findings from the STarT MSK feasibility and pilot cluster randomized controlled trial.BMC family practice · 2020Trial
- Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial.Pain medicine (Malden, Mass.) · 2016Trial
- Mindfulness Meditation-Based Intervention Is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy.Journal of alternative and complementary medicine (New York, N.Y.) · 2016Trial
- Trial
- A multidisciplinary primary care team consultation in a socio-economically deprived community: an exploratory randomised controlled trial.BMC health services research · 2011Trial
- The UQTR university-based chiropractic clinic cohort (UQTRChiCo): description and summary of an available data source for research collaborations.Chiropractic & manual therapies · 2026Article
- Management of older adults consulting in GP surgery practices with back pain in UK Clinical Practice Research Datalink Aurum: population based study.BMC musculoskeletal disorders · 2026Article
- Knowledge and practices of young general practitioners with regard to knee and epidural infiltrations in Cameroon.BMC primary care · 2025Article
- Acceptability of self-completion versus face-to-face use of a vertebral fragility fracture clinical decision tool for use in older people with back pain in the UK.Archives of osteoporosis · 2025Article
- Evaluating an early Interdisciplinary Multimodal Assessment for Patients at Risk of Developing Chronic Pain: Results of a Multicentre RCT in Germany.Pain and therapy · 2025Article
- Review
- Observational
- Observational
- Quantifying the population burden of musculoskeletal disorders, including impact on sickness absence: analysis of national Scottish data.Rheumatology advances in practice · 2022Article
- Plain lumbosacral X-rays for low back pain: Findings correlate with clinical presentation in primary care settings.Journal of family medicine and primary care · 2020Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMost patients seeking help for back pain are managed in primary care.
aimTo describe the content and outcome of 'usual care' for low back pain in primary care trials. DESIGN OF STUDY: A systematic review of randomised controlled trials published since 1998.
settingPrimary care.
methodRandomised controlled trials of back pain in adults were scrutinised to obtain data on treatment and outcome measures in groups receiving usual primary care. A narrative review of the resulting heterogeneous data was undertaken.
resultsThirty-three papers were identified for analysis. Overall the exact nature of the treatment received in the 'usual' primary care group was poorly recorded. Medication was frequently used, and there were suggestions that levels of opioid prescription were higher than might be expected from clinical guidelines. Requesting of plain-film X-rays occurred more often than recommended. There was very little information to suggest that doctors were promoting physical activity for patients with back pain. Disability scores (Roland-Morris Disability Questionnaire) and pain scores improved over time for patients with acute or subacute back pain, but not for those with chronic pain.
conclusionTreatment received by patients with back pain was varied and often not in line with back-pain guidelines, particularly with respect to opioid prescription and X-ray investigation. The content of the 'usual care' arm in trials is crucial to interpreting the outcome of studies, but was poorly described in the papers reviewed. Future trials should more fully describe the 'usual care' arm.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.