Abstract
BackgroundAlthough shared decision-making (SDM) is increasingly accepted in healthcare and has demonstrated merits for several psychological outcomes, the effect on recovery from somatic conditions is still subject to debate. The objective of this study is to measure the effect of SDM on recovery from non-chronic aspecific low back pain (LBP).MethodsThis study is a post-hoc analysis of data from a cluster-randomised trial that evaluated the effectiveness of SDM on recovery in patients with non-chronic aspecific LBP. In this analysis, we re-evaluate the impact of SDM from three perspectives: that of external observers, participating GPs and participating patients. Recovery was measured with the Visual Analogue Scale (VAS) for pain and with the Roland Morris Disability questionnaire (RMD) and defined as a VAS < 30 and an RMD < 4. Logistic regression was used to analyse the effect of SDM on recovery at 6 and 26 weeks.ResultsAt 26 weeks, 105 (74%) of all 176 included patients had recovered. No significant effect of SDM on recovery at 6 or 26 weeks after the consultation was found when considering SDM from an observer perspective or a patient perspective. From a GP perspective SDM had a significant effect on recovery, but at 26 weeks only, and with the lowest probability of recovery observed at a medium level of GP-perceived SDM.ConclusionsWe found no evidence that SDM as perceived by the patient or by external observation improves recovery from non-chronic aspecific low back pain. The long-term recovery may be better for patients in whom the GP perceives SDM during their consultations. Further research should highlight the hierarchy and the relation between the perspectives, which is needed to come to an integral effect evaluation of SDM.Trial registrationThe Netherlands National Trial Register (NTR) number: NTR1960.
Highlights
Shared decision-making (SDM) is increasingly accepted in healthcare and has demonstrated merits for several psychological outcomes, the effect on recovery from somatic conditions is still subject to debate
We previously reported the results of a randomised controlled trial (RCT) in general practice examining the effects of training General practitioner (GP) in shared decision-making (SDM) in patients suffering from non-chronic low back pain (LBP), with SDM measured from the observer perspective only [9, 17, 18]
Baseline characteristics GP and patient characteristics, patient recovery rates and the numbers of missing data are provided in Table 1 for the participants in this post-hoc analysis
Summary
Shared decision-making (SDM) is increasingly accepted in healthcare and has demonstrated merits for several psychological outcomes, the effect on recovery from somatic conditions is still subject to debate. Aspecific low back pain (LBP), i.e. back pain without a known specific somatic origin, is among the top 10 most frequently presented complaints in primary care [1]. It subsides within 2 weeks in the majority of patients but Sanders et al BMC Primary Care (2022) 23:22 can become chronic (> 3 months) or frequently recurring (≥3 episodes a year) [1]. Worldwide, it is one of the leading causes of disability, with a societal burden primarily incurred through costs related to losses in productivity (93% of total costs) [2, 3]. The concept is increasingly accepted in healthcare, the implementation of SDM in clinical practice varies significantly, depending on the perspective of patients, providers or external observers [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
