‘Reassurance and health care seeking in people with persistent musculoskeletal low back pain consulting orthopaedic spine practitioners: A prospective cohort study’.

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Guidelines recommend self-management for most people living with persistent musculoskeletal low back pain (PMLBP) when surgery is ruled out. Conveying this message to patients can be challenging. This study examined patients’ perceptions of reassuring communications from surgical spine team practitioners attempting to deliver this message in a single consultation.Pre-consultation baseline measures included levels of pain, disability, and previous consultation history. Patients perceptions of reassuring communications were measured within one-week post consultation. The outcome variables, measured at 3-month follow-up, included patients report of subsequent GP visits for back pain, the number of other health care providers consulted for back pain, and distress.Data from 296 patients (9.8% loss to follow up) was analysed using hierarchical regression models, controlling for demographic, clinical and study-related factors. In each model, perceived reassurance accounted for a small but significant variance, above and beyond other predictors. Further GP visits were predicted by disability at baseline and perceived reassurance (adjusted R2 of 14.6%). Subsequent consultations with any health care professionals were predicted by a shorter duration of back pain, disability at baseline and perceived reassurance (adj. R2 = 10.6%). Distress was predicted by older age, disability and reassurance (adj. R2 = 59.5%).Findings suggest that better communication in consultations with orthopaedic spine clinicians might help reduce unnecessary subsequent health care utilization and distress.

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Authors: Kathrin Braeuninger-Weimer, Hanna Rooslien, Naffis Anjarwalla, Tamar Pincus