Abstract
BackgroundLow back pain is a leading cause of disability worldwide. Health literacy has been associated with pain intensity and pain control. However, there is a paucity of evidence regarding this association. In the field of low back pain research, inconsistent reporting of outcomes has been highlighted. To address this issue a Core Outcome Set has been developed.ObjectivesThe objectives of this scoping review were: (1) The health literacy measures currently employed for low back pain and the aspects of health literacy they include. (2) The low back pain health outcomes included in such work. (3) The extent to which these health outcomes reflect the Core Outcome Set for Clinical Trials in Non-Specific Low Back Pain.MethodsThe search included thirteen bibliographic databases, using medical subject heading terms for low back pain and health literacy, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. The eligibility criteria were defined by the Joanna Briggs Institute PCC mnemonic. A thematic framework approach was used for analysis.ResultsThe search yielded ten relevant studies for inclusion, amongst which a total of nine health literacy measures and 50 health outcome measures were used. Most health literacy measures focused on functional health literacy, with few assessing communicative and critical health literacy. The health outcomes assessed by the included studies could be broadly categorised into: Pain, Disability, Behaviour, Knowledge and Beliefs, and Resource Utilisation. Most of these outcome measures studied (36 out of 50) did not directly reflect the Core Outcome Set for Clinical Trials in Non-Specific Low Back Pain.ConclusionsTo allow for comparison across findings and the development of a rigorous evidence base, future work should include the Core Outcome Set for Clinical Trials in Non-Specific Low Back Pain. There is an urgent need to broaden the evidence-base to include regions where low back pain morbidity is high, but data is lacking. Such work demands the incorporation of comprehensive measures of health literacy that have both generic and culturally sensitive components.
Highlights
Such work demands the incorporation of comprehensive measures of health literacy that have both generic and culturally sensitive components
We will discuss our results in the context of the three objectives and the implications for evidence and future research i.e. (1) The health literacy measures currently employed for low back pain and the aspects of health literacy they include; (2) The low back pain health outcomes included in such work; (3) The extent to which these health outcomes reflect the Core Outcome Set for Clinical Trials in Non-Specific Low Back Pain
The ten relevant studies included in this review yielded a total of nine different measures of health literacy (HL) and 50 measures of Low back pain (LBP) health outcomes
Summary
In the field of low back pain research, inconsistent reporting of outcomes has been highlighted To address this issue a Core Outcome Set has been developed. The concept of HL is extensive and incorporates functional, communicative and critical domains [13] It is defined as “the achievement of a level of knowledge, personal skills and confidence to take action to improve personal and community health by changing personal lifestyles and living conditions” [14]. At its core is an observable set of skills that can be developed and improved through effective communication and education to enhance autonomy and empower people to make decisions relating to their health and changing circumstances [14, 15]. Independent of other socio-demographic factors, low HL is associated with higher mortality amongst older people, poorer health outcomes, and higher morbidity [17,18,19]. Higher HL is linked to lower pain intensity and better pain control among those with chronic pain [1, 20]
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