Trial reportBMC family practice2021
Patient education booklet to support evidence-based low back pain care in primary care - a cluster randomized controlled trial.
Trial report in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Patient education materials for non-specific low back pain and sciatica: A systematic review and meta-analysis.PloS one · 2022Pooled it
- PRIME - A multilevel intervention for low back pain management in primary care: Protocol for an effectiveness-implementation hybrid type 1 cluster randomized controlled trial.Contemporary clinical trials communications · 2026Article
- Attitudes, Beliefs, and Clinical Decision-Making Regarding Low Back Pain: A Cross-Sectional Study of Pakistani Medical Practitioners, Physiotherapists, and Exercise Professionals.Musculoskeletal care · 2026Article
- Development and proof-of-concept of a complex intervention to support appropriate imaging for musculoskeletal pain: the Betti programme.Implementation science communications · 2026Article
- Effectiveness of strategies for implementing guideline-concordant care in low back pain: a systematic review and meta-analysis of randomised controlled trials.EClinicalMedicine · 2025Article
- Accessible Patient Education Materials for Low Back Pain Rarely Meet People's Information Needs: A Scoping Review.Musculoskeletal care · 2025Article
- Effectiveness of different de-implementation strategies in primary care: systematic review and meta-analysis.BMJ medicine · 2025Article
- Effect of training on knowledge, behaviors, and low back pain among marble workers: non-randomized experimental study.Frontiers in public health · 2025Article
- Factors associated with patients' demand for low-value care: a scoping review.BMC health services research · 2024Article
- Article
- Effectiveness of strategies for implementing guideline-concordant care in low back pain: a systematic review and meta-analysis of randomised controlled trials.EClinicalMedicine · 2024Article
- An Evaluation of the Design of Multimedia Patient Education Materials in Musculoskeletal Health Care: Systematic Review.JMIR rehabilitation and assistive technologies · 2024Review
- Effectiveness of a classification-based approach to low back pain in primary care - a benchmarking controlled trial.Journal of rehabilitation medicine · 2024Article
- An Early Biopsychosocial Intervention Design for the Prevention of Low Back Pain Chronicity: A Multidisciplinary Empirical Approach.Journal of rehabilitation medicine · 2022Article
- Patients with low back pain presenting for chiropractic care who want diagnostic imaging are more likely to receive referral for imaging: a cross-sectional study.Chiropractic & manual therapies · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInappropriate imaging and low-value care for low back pain (LBP) are common. A new patient-education booklet was created to overcome identified barriers to the delivery of recommended care, including the use of inappropriate imaging. Our aim was to assess the effectiveness of this booklet as part of primary care for LBP patients in comparison to usual care.
methodsA cluster-randomized trial was performed. The intervention involved providing practitioners with the new patient-education booklet and a 30-min training session on its use. The booklet was provided during the clinical consult to all consenting LBP patients in the intervention group. Primary outcomes were the proportion of patients presenting with LBP who underwent imaging examinations during the first three months of follow-up and PROMIS PF-20 (Patient-Reported Outcomes Measurement Information System, 20-item physical functioning short form) change between baseline and three-month follow-up. Secondary outcomes, including sick leave and imaging examinations at 12 months, were investigated. Logistic regression using GEE-estimation was used for dichotomous outcomes, Poisson regression using GEE-estimation for count outcomes, and linear mixed models for continuous outcomes.
resultsUsing the patient education booklet appeared to substantially reduce the proportion of LBP patients who underwent an imaging examination at three months, but the result was not statistically significant (OR 0.57, 95% confidence interval (Cl) 0.27 to 1.22). At 12 months, the effect was slightly larger and statistically significant (OR 0.50, 95%Cl 0.30 to 0.83, p = 0.008). No difference was observed in the PROMIS PF-20 T-score change between baseline and 3 months or 12 months (p = 0.365 and p = 0.923, respectively). The number of sick leave days in the intervention group was less than that in the control group at 3 months (RR 0.47, 95%Cl 0.26 to 0.83, p = 0.010) and at 12 months (RR 0.36, 95%Cl 0.18 to 0.72, p = 0.004).
conclusionsThe booklet appeared to be effective in reducing the proportion of LBP patients who underwent imaging examinations over 12 months. The intervention had no discernible effect on the PROMIS PF20 T-score change. The number of sick leave days was substantially lower in the intervention group.
trial registrationISRCTN, ISRCTN14389368 , Registered 4 April 2019-Retrospectively registered.
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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.