Evidence map›Paper›PMID 34674677›Full record

ArticleBMC musculoskeletal disorders2021

Improving consultations for persistent musculoskeletal low back pain in orthopaedic spine settings: an intervention development.

Kathrin Braeuninger-Weimer, Naffis Anjarwalla, Alison McGregor, Lisa Roberts, Philip Sell, Tamar Pincus

Open access · goldAbstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Kathrin Braeuninger-WeimerDepartment of Psychology, Royal Holloway, University of London, Egham, Surrey, UK.
Naffis AnjarwallaDepartment of Orthopaedics, Wexham Park Hospital, Slough, Berkshire, UK.
Alison McGregorDepartment of Surgery and Cancer, Imperial College London, London, UK.
Lisa RobertsSchool of Health Sciences, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK.
Philip SellDepartment of Orthopaedics, Leicester University Hospitals, Leicester, UK.
Tamar PincusDepartment of Psychology, Royal Holloway, University of London, Egham, Surrey, UK. T.Pincus@rhul.ac.uk.
Royal Holloway University of London · GBImperial College London · GBUniversity Hospitals of Leicester NHS Trust · GBUniversity of Southampton · GBWexham Park Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is a need to improve consultations between patients with persistent musculoskeletal low back pain and orthopaedic spine clinicians when surgery is not indicated. Poor communication and lack of education about self- management in these consultations have been shown to be associated with increased distress and higher subsequent health care seeking.

aimTo develop a standardised intervention to improve spine care consultations for patients for whom surgery is not beneficial.

methodThe intervention was developed in six stages. The first three stages included: interviews with patients, an interactive workshop with clinicians from a mix of disciplines, and interviews with spine clinicians about their perspective of the recommendations, their perceived difficulties and potential improvements. Information from these stages was synthesised by an expert panel, creating a draft intervention structure and content. The main features of the intervention and the materials developed were then reviewed by patients and spine clinicians. Finally, the research team incorporated the recommended amendments to produce the intervention.

resultsIn total, 36 patients and 79 clinicians contributed to the development of the intervention. The final intervention includes three components: a pre-consultation letter with information suggesting that surgery is one possible intervention amongst many, introducing the staff, and alerting patients to bring with them a potted history of interventions tried previously. The intervention includes short online training sessions to improve clinicians' communication skills, during the consultation, in reference to listening skills, validation of patients' pain, and use of appropriate language. Clinicians are also supplied with a list of evidence-based sources for advice and further information to share with patients. Finally, post consultation, a follow up letter includes a short summary of the patients' clinical journey, the results of their examination and tests, and a reminder of recommendations for self-management.

conclusionThe intervention includes aspects around patient education and enhanced clinician skills. It was developed with input from a multitude of stakeholders and is based on patients' perceptions of what they would find reassuring and empowering when surgery is excluded. The intervention has the potential to improve the patients care journey and might lead to changes in practice in spine clinicians.

Indexed as

Low Back PainOrthopedicsSelf-ManagementHumansPatient Acceptance of Health CareReferral and ConsultationMusculoskeletal low back painReassuranceSpinal care

Identifiers

PMID34674677
PMCPMC8532354
OpenAlexW3207856079

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.