Abstract
BackgroundThe biopsychosocial model is recommended in the management of non-specific low back pain but musculoskeletal practitioners can lack skills in assessing and managing patients using a biopsychosocial framework. Educational interventions have produced equivocal results. There is a need for an alternative educational tool to support practitioners’ development in the application of biopsychosocial model to manage low back pain.MethodsA mixed methods study assessed the feasibility and acceptability of an e-learning programme on the biopsychosocial management of non-specific low back pain for osteopaths with more than 15 years’ experience. A sequential explanatory design was conducted, with a feasibility randomised controlled trial and semi-structured interviews explored with thematic analysis.ResultsA total of 45 participants participated in the RCT of which 9 also participated in the interview study. The a-priori sample size was not met (45 instead of 50). The recruitment strategies, randomisation, retention, data collection and outcome measures worked well and were found to be feasible for a main trial. The retention, satisfaction and participants’ views of the programme demonstrated a good acceptability of the programme. Data from the semi-structured interviews were organised in three themes, the first two were related to the feasibility and acceptability of the e-learning programme (practical experience of following the course and engagement with the content) and the third relates to the impact of the intervention (perception of the BPS model).ConclusionA main RCT is feasible and the intervention was received well by the participants. A main RCT is required to assess the effectiveness of the e-learning programme. This work also provided data on aspects so far unreported, including osteopaths’ views on continuing professional development, on e-learning as a form of continuing professional development and osteopaths’ perceptions and challenges concerning the implementation of the biopsychosocial model in practice.
Highlights
The biopsychosocial model is recommended in the management of non-specific low back pain but musculoskeletal practitioners can lack skills in assessing and managing patients using a biopsychosocial framework
It was uncertain if an e-learning course could be used to train osteopaths to the biopsychosocial model
Aim/objectives Following the Medical Research Council’s guidance for the development of complex interventions [15], the aim of this study was to assess the feasibility of a main Randomised controlled trial (RCT) and the acceptability of using an e-learning programme to train osteopaths in the BPS management of non-specific low back pain (NSLBP), who had not been exposed to the BPS model during their undergraduate training
Summary
The biopsychosocial model is recommended in the management of non-specific low back pain but musculoskeletal practitioners can lack skills in assessing and managing patients using a biopsychosocial framework. The biopsychosocial (BPS) model has been recommended in the management of non-specific low back pain (NSLBP) for nearly 15 years [12, 54, 55] as NSLBP is multifactorial and BPS factors, such as sleep disorder or depression, are shown to predict pain and disability outcomes [19, 20, 27, 61]. These factors have become targets for intervention [36, 76]. One end being a biomedical orientation is: “a mechanistic view of the body, in which illness is a fault in the machine that should be fixed” [81] “and any psychologic element being relatively unimportant or secondary to the physical disorder” [80].
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