Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial
Abstract Background Low back pain (LBP) is a multifactorial condition with individual and societal impact that affects populations globally. Current guidelines for the treatment of LBP recommend pharmacological and non-pharmacological strategies. The aim of this study was to compare usual clinical p...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-019-4810-x |
| _version_ | 1819058720468893696 |
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| author | Romina Raczy Mas Tomàs López-Jiménez Enriqueta Pujol-Ribera María Isabel Fernández-San Martín Jenny Moix-Queraltó Elena Montiel-Morillo Teresa Rodríguez-Blanco Marc Casajuana-Closas M. J. González-Moneo Ester Núñez Juárez Montse Núñez Juárez Mercè Roura-Olivan Raquel Martin-Peñacoba Magda Pie-Oncins Montse Balagué-Corbella Miguel-Ángel Muñoz Concepción Violan Anna Berenguera |
| author_facet | Romina Raczy Mas Tomàs López-Jiménez Enriqueta Pujol-Ribera María Isabel Fernández-San Martín Jenny Moix-Queraltó Elena Montiel-Morillo Teresa Rodríguez-Blanco Marc Casajuana-Closas M. J. González-Moneo Ester Núñez Juárez Montse Núñez Juárez Mercè Roura-Olivan Raquel Martin-Peñacoba Magda Pie-Oncins Montse Balagué-Corbella Miguel-Ángel Muñoz Concepción Violan Anna Berenguera |
| author_sort | Romina Raczy Mas |
| collection | DOAJ |
| description | Abstract Background Low back pain (LBP) is a multifactorial condition with individual and societal impact that affects populations globally. Current guidelines for the treatment of LBP recommend pharmacological and non-pharmacological strategies. The aim of this study was to compare usual clinical practice with the effectiveness of a biopsychosocial multidisciplinary intervention in reducing disability, severity of pain and improving quality of life in a working population of patients with subacute (2–12 weeks), non-specific LBP. Methods Longitudinal cluster randomized clinical trial conducted in 39 Primary Health Care Centres (PHCC) of Barcelona, with patients aged 18–65 years (n = 501; control group = 239; 26 PHCC, intervention group = 262; 13 PHCC). The control group received usual clinical care. The intervention group received usual clinical care plus a biopsychosocial multidisciplinary intervention, which consisted of physiotherapy, cognitive-behavioural therapy and medication. The main outcomes were changes in the Roland Morris Disability Questionnaire (RMDQ), and the minimal clinically important differences. Secondary outcomes were changes in the McGill Pain (MGPQ) and Quality of Life (SF-12) questionnaires. Assessment was conducted at baseline, 3 and 12 months. Analysis was by intention-to-treat and analyst-blinded. Multiple imputations were used. Results Of the 501 enrolled patients, 421 (84%) provided data at 3 months, and 387 (77.2%) at 12 months. Mean age was 46.8 years (SD: 11.5) and 64.7% were women. In the adjusted analysis of the RMDQ outcome, only the intervention group showed significant changes at 3 months (− 1.33 points, p = 0.005) and at 12 months (− 1.11 points, p = 0.027), but minimal clinically important difference were detected in both groups. In the adjusted analysis of the RMDQ outcome, the intervention group improvement more than the control group at 3 months (− 1.33 points, p = 0.005) and at 12 months (− 1.11 points, p = 0.027). The intervention group presented a significant difference. Both groups presented a minimal clinically important difference, but more difference in the intervention group. The intervention group presented significant differences in the MGPQ scales of current pain intensity and VAS scores at 3 months. No statistically significant differences were found in the physical and mental domains of the SF-12. Conclusions A multidisciplinary biopsychosocial intervention in a working population with non-specific subacute LBP has a small positive impact on disability, and on the level of pain, mainly at short-term, but no difference on quality of life. Trial registration ISRCTN21392091 (17 oct 2018) (Prospectively registred). |
| first_indexed | 2024-12-21T13:59:41Z |
| format | Article |
| id | doaj.art-12789d4cf36e49c596a146f678566494 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-21T13:59:41Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-12789d4cf36e49c596a146f6785664942022-12-21T19:01:24ZengBMCBMC Health Services Research1472-69632019-12-011911910.1186/s12913-019-4810-xEffectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trialRomina Raczy Mas0Tomàs López-Jiménez1Enriqueta Pujol-Ribera2María Isabel Fernández-San Martín3Jenny Moix-Queraltó4Elena Montiel-Morillo5Teresa Rodríguez-Blanco6Marc Casajuana-Closas7M. J. González-Moneo8Ester Núñez Juárez9Montse Núñez Juárez10Mercè Roura-Olivan11Raquel Martin-Peñacoba12Magda Pie-Oncins13Montse Balagué-Corbella14Miguel-Ángel Muñoz15Concepción Violan16Anna Berenguera17Gerència Territorial de Barcelona, Catalan Institute of HealthInstitut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol)Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol)Gerència Territorial de Barcelona, Catalan Institute of HealthDepartment of Basic, Evolutionary and Educational Psychology, Universitat Autònoma de Barcelona Faculty of PsychologyHospital de la Santa Creu i de Sant PauInstitut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol)Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol)Primary Care Centre Sant MartíSAP Support to Diagnosis and Treatment, Gerència Territorial de Barcelona, Catalan Institute of HealthUnit of Functional Rehabilitation, Department of Rheumatology, Hospital Clínic UniversitariPrimary Care Centre Sant AndreuPrimary Care Centre Sant AntoniPrimary Care Centre Sant MartíInstitut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol)Gerència Territorial de Barcelona, Catalan Institute of HealthInstitut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol)Institut Universitari d’Investigació en Atenció Primària (IDIAP Jordi Gol)Abstract Background Low back pain (LBP) is a multifactorial condition with individual and societal impact that affects populations globally. Current guidelines for the treatment of LBP recommend pharmacological and non-pharmacological strategies. The aim of this study was to compare usual clinical practice with the effectiveness of a biopsychosocial multidisciplinary intervention in reducing disability, severity of pain and improving quality of life in a working population of patients with subacute (2–12 weeks), non-specific LBP. Methods Longitudinal cluster randomized clinical trial conducted in 39 Primary Health Care Centres (PHCC) of Barcelona, with patients aged 18–65 years (n = 501; control group = 239; 26 PHCC, intervention group = 262; 13 PHCC). The control group received usual clinical care. The intervention group received usual clinical care plus a biopsychosocial multidisciplinary intervention, which consisted of physiotherapy, cognitive-behavioural therapy and medication. The main outcomes were changes in the Roland Morris Disability Questionnaire (RMDQ), and the minimal clinically important differences. Secondary outcomes were changes in the McGill Pain (MGPQ) and Quality of Life (SF-12) questionnaires. Assessment was conducted at baseline, 3 and 12 months. Analysis was by intention-to-treat and analyst-blinded. Multiple imputations were used. Results Of the 501 enrolled patients, 421 (84%) provided data at 3 months, and 387 (77.2%) at 12 months. Mean age was 46.8 years (SD: 11.5) and 64.7% were women. In the adjusted analysis of the RMDQ outcome, only the intervention group showed significant changes at 3 months (− 1.33 points, p = 0.005) and at 12 months (− 1.11 points, p = 0.027), but minimal clinically important difference were detected in both groups. In the adjusted analysis of the RMDQ outcome, the intervention group improvement more than the control group at 3 months (− 1.33 points, p = 0.005) and at 12 months (− 1.11 points, p = 0.027). The intervention group presented a significant difference. Both groups presented a minimal clinically important difference, but more difference in the intervention group. The intervention group presented significant differences in the MGPQ scales of current pain intensity and VAS scores at 3 months. No statistically significant differences were found in the physical and mental domains of the SF-12. Conclusions A multidisciplinary biopsychosocial intervention in a working population with non-specific subacute LBP has a small positive impact on disability, and on the level of pain, mainly at short-term, but no difference on quality of life. Trial registration ISRCTN21392091 (17 oct 2018) (Prospectively registred).https://doi.org/10.1186/s12913-019-4810-xPrimary health careMultidisciplinary biopsychosocial interventionNon-specific subacute low back painDisabilityPainQuality of life |
| spellingShingle | Romina Raczy Mas Tomàs López-Jiménez Enriqueta Pujol-Ribera María Isabel Fernández-San Martín Jenny Moix-Queraltó Elena Montiel-Morillo Teresa Rodríguez-Blanco Marc Casajuana-Closas M. J. González-Moneo Ester Núñez Juárez Montse Núñez Juárez Mercè Roura-Olivan Raquel Martin-Peñacoba Magda Pie-Oncins Montse Balagué-Corbella Miguel-Ángel Muñoz Concepción Violan Anna Berenguera Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial BMC Health Services Research Primary health care Multidisciplinary biopsychosocial intervention Non-specific subacute low back pain Disability Pain Quality of life |
| title | Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial |
| title_full | Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial |
| title_fullStr | Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial |
| title_full_unstemmed | Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial |
| title_short | Effectiveness of a multidisciplinary BIOPSYCHOSOCIAL intervention for non-specific SUBACUTE low back pain in a working population: a cluster randomized clinical trial |
| title_sort | effectiveness of a multidisciplinary biopsychosocial intervention for non specific subacute low back pain in a working population a cluster randomized clinical trial |
| topic | Primary health care Multidisciplinary biopsychosocial intervention Non-specific subacute low back pain Disability Pain Quality of life |
| url | https://doi.org/10.1186/s12913-019-4810-x |
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