Acute low back pain patient satisfaction one year after presenting to primary care

Abstract

Listen

Translate article

the authors point out that satisfaction relating to LBP has been little explored in the literature. This paper aims to use data collected at the initial patient visit to, firstly, predict satisfaction with symptoms and satisfaction with care at a 12-month follow up, and secondly, to determine the association between satisfaction, recovery from LBP and pain intensity at a 12-month follow up. This study is a secondary analysis of a longitudinal cohort study, in which a consecutive sample of 1328 patients from 1343 potential patients with acute LBP for more than six weeks, in an area bounded by T12 to the gluteal fold with or without leg pain, were followed for one year. The participants were recruited in Sydney, Australia from primary care practitioners (physiotherapists, chiropractors, medical practitioners) spread across varying socioeconomic levels (by postcode) according to the 2001 Australian census. An initial baseline questionnaire describes the cohort. Predictors were chosen from the literature and grouped into personal, psychological or back pain related variables. Two satisfaction measures, put as questions to the patients at 12 months, were devised from a panel of LBP experts using a five-point Likert scale e very dissatisfied to very satisfied. Follow-up measures included number of visits to the practitioner, if fully recovered then how many days it took for recovery, and LBP intensity and disability levels. The population baseline was defined with descriptive statistics. Prediction models were then developed usingvariableswithasignificantassociationwithoneofthetwosatisfactionmeasuresandthenusingtheory and statistical approaches, groups of variables were added in order of the psychological, personal and LBP groupings to the predictive models and then further re-evaluated for their predictive value. Higher satisfaction levels were recorded for those who had fewer visits to their practitioner, fewer days to recovery and lower 12-month pain scores. Overall 76% of patients were very satisfied with their care and 55% were very satisfied with their symptoms. Several variables measured at the initial consultation and corrected for pain intensity were predictors of higher satisfaction results. The variables with a strong positive association were patients born in Australia, who were older and had fewer symptoms of depression. When considering satisfaction with symptoms, the predictive variables were symptoms of depression and poor self-rated health. Further practice based research might usefully consider collecting data related to these variables on a new patient form and utilizing it in clinical decision-making and prognostication to assist in improving patient outcomes.