Outcomes research in non-specific low back pain : Knowledge transfer in clinical practice.

Tanja A Stamm,Anna Boesendorfer,Valentin Ritschl,Siniša Štefanac,Maisa Omara,Erika Mosor

doi:10.1007/s00508-019-1523-4

Tanja A Stamm, Anna Boesendorfer + Show 4 more

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https://doi.org/10.1007/s00508-019-1523-4

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SummaryObjectiveThe aims of this article are to provide an overview and discuss current concepts and future trends in outcomes research in non-specific low back pain, specifically considering the perspective of patients, patient-reported outcomes and outcome measures as well as to facilitate knowledge transfer into clinical practice.Review strategyThe breadth of this work and the required brevity of this article were not amenable to a formal approach, such as a systematic literature review or a formal scoping review. Literature sources were identified through medical databases but different sources of information and of various methodologies were also included. Furthermore, outcomes meaningful for patients and examples of outcome measures that are applicable in clinical practice were extracted. Areas for future research were identified and discussed.ResultsPatient-reported outcomes and outcome measures are essential in patient-centered care. The assessment of the patients’ perspective is important to ensure motivation, active involvement, self-management and adherence, especially in non-pharmacological interventions for low back pain. To facilitate the use of outcome measurements for low back pain in clinical practice, future studies should focus on a clinically feasible index, which includes patient-reported as well as clinician-reported or performance-based variables. Relationships between different types of outcomes and outcome measures as well as resource and outcome-based healthcare constitute important topics for future research. New digital technologies can support continuous outcome measurement and might enable new patient-driven models of care.ConclusionActive patient involvement is an essential part of non-pharmacological treatment in low back pain and needs to be considered in terms of outcomes and outcome measurement.

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Due to the increased longevity of the population in industrialized countries, global priorities in healthcare have been shifting from communicable to noncommunicable diseases [1]
Active patient involvement is an essential part of non-pharmacological treatment in low back pain and needs to be considered in terms of outcomes and outcome measurement
The latest recommendation that resulted from a systematic review [28] is to use the Oswestry Disability Index version 2.1a or the 24-item Roland Morris Disability Questionnaire for physical functioning, an 11-point numeric rating scale referring to average low back pain intensity over the last week for pain intensity, the Short Form Health Survey 12 or the 10-item Patient-Reported Outcomes Measurement Information System Global Health form for health-related quality of life [19]; many authors [29] suggest adding further domains to the assessment of low back pain, such as measuring current work ability and psychological functioning

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Patient-reported outcomes and outcome measures are essential in patient-centered care. To facilitate the use of outcome measurements for low back pain in clinical practice, future studies should focus on a clinically feasible index which includes patient-reported, along with clinician-reported or performance-based variables. Relationships between different types of outcomes and outcome measures as well as resource and outcome-based healthcare constitute important topics for future research. Mosor declare that they have no conflict of interest related to this work.

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