Assessment of health-related quality of life and patient’s knowledge in chronic non-specific
      low back pain

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Abstract

Background

Chronic non-specific low back pain syndrome (cnsLBP) is a severe health problem in developed countries, which has an important effect on patients’ quality of life and is highly determined by socio-demographic factors and low back pain specific knowledge. We examined patients’ health-related quality of life according to the results of the Short Form Health Survey (SF-36), low back pain knowledge (LBPKQ) and the social determinants of the participants.

Methods

We carried out our research in the first half of 2015 in Southern Transdanubia, Hungary. The examination included 1155 respondents living with chronic non-specific low back pain. The confidence interval of 95% was used, and the level of.

significance was p < 0.05 using SPSS 22.0 software.

Results

The SF-36 questionnaire is suitable for the examination of patients’ health-related quality of life (Cronbach’s Alpha> 0.76), as the LBPKQ’s Cronbach’s Alpha was 0.726 also, which showed good validity. Longer-term disease meant a lower health-related quality of life ( p < 0.05). A greater decrease of function (Roland Morris scores (RM)) accounts for a lower HRQoL and higher knowledge level. We found significant differences in LBPKQ scores according to sociodemographic parameters. The general health status was positively correlated with LBPKQ ( p = 0.024) adjusted for demographic and pain and functional status.

Conclusion

The negative effect of the symptoms on patients’ quality of life is proved, which is determined by different socio-demographic parameters furthermore by knowledge. Above all could be useful information for professionals to adopt the right interventions.

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Most cited references 36

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A systematic review of low back pain cost of illness studies in the United States and internationally.

Simon Dagenais, Jaime Caro, Scott Haldeman (2008)

The economic burden of low back pain (LBP) is very large and appears to be growing. It is not possible to impact this burden without understanding the strengths and weaknesses of the research on which these costs are calculated. To conduct a systematic review of LBP cost of illness studies in the United States and internationally. Systematic review of the literature. Medline was searched to uncover studies about the direct or indirect costs of LBP published in English from 1997 to 2007. Data extracted for each eligible study included study design, population, definition of LBP, methods of estimating costs, year of data, and estimates of direct, indirect, or total costs. Results were synthesized descriptively. The search yielded 147 studies, of which 21 were deemed relevant; 4 other studies and 2 additional abstracts were found by searching reference lists, bringing the total to 27 relevant studies. The studies reported on data from Australia, Belgium, Japan, Korea, the Netherlands, Sweden, the UK, and the United States. Nine studies estimated direct costs only, nine indirect costs only, and nine both direct and indirect costs, from a societal (n=18) or private insurer (n=9) perspective. Methodology used to derive both direct and indirect cost estimates differed markedly among the studies. Among studies providing a breakdown on direct costs, the largest proportion of direct medical costs for LBP was spent on physical therapy (17%) and inpatient services (17%), followed by pharmacy (13%) and primary care (13%). Among studies providing estimates of total costs, indirect costs resulting from lost work productivity represented a majority of overall costs associated with LBP. Three studies reported that estimates with the friction period approach were 56% lower than with the human capital approach. Several studies have attempted to estimate the direct, indirect, or total costs associated with LBP in various countries using heterogeneous methodology. Estimates of the economic costs in different countries vary greatly depending on study methodology but by any standards must be considered a substantial burden on society. This review did not identify any studies estimating the total costs of LBP in the United States from a societal perspective. Such studies may be helpful in determining appropriate allocation of health-care resources devoted to this condition.

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A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

Marienke van Middelkoop, Sidney Rubinstein, Ton Kuijpers … (2010)

Low back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of physical and rehabilitation interventions (i.e. exercise therapy, back school, transcutaneous electrical nerve stimulation (TENS), low level laser therapy, education, massage, behavioural treatment, traction, multidisciplinary treatment, lumbar supports, and heat/cold therapy) for chronic LBP. The primary search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro up to 22 December 2008. Existing Cochrane reviews for the individual interventions were screened for studies fulfilling the inclusion criteria. The search strategy outlined by the Cochrane Back Review Groups (CBRG) was followed. The following were included for selection criteria: (1) randomized controlled trials, (2) adult (≥18 years) population with chronic (≥12 weeks) non-specific LBP, and (3) evaluation of at least one of the main clinically relevant outcome measures (pain, functional status, perceived recovery, or return to work). Two reviewers independently selected studies and extracted data on study characteristics, risk of bias, and outcomes at short, intermediate, and long-term follow-up. The GRADE approach was used to determine the quality of evidence. In total 83 randomized controlled trials met the inclusion criteria: exercise therapy (n = 37), back school (n = 5), TENS (n = 6), low level laser therapy (n = 3), behavioural treatment (n = 21), patient education (n = 1), traction (n = 1), and multidisciplinary treatment (n = 6). Compared to usual care, exercise therapy improved post-treatment pain intensity and disability, and long-term function. Behavioural treatment was found to be effective in reducing pain intensity at short-term follow-up compared to no treatment/waiting list controls. Finally, multidisciplinary treatment was found to reduce pain intensity and disability at short-term follow-up compared to no treatment/waiting list controls. Overall, the level of evidence was low. Evidence from randomized controlled trials demonstrates that there is low quality evidence for the effectiveness of exercise therapy compared to usual care, there is low evidence for the effectiveness of behavioural therapy compared to no treatment and there is moderate evidence for the effectiveness of a multidisciplinary treatment compared to no treatment and other active treatments at reducing pain at short-term in the treatment of chronic low back pain. Based on the heterogeneity of the populations, interventions, and comparison groups, we conclude that there are insufficient data to draw firm conclusion on the clinical effect of back schools, low-level laser therapy, patient education, massage, traction, superficial heat/cold, and lumbar supports for chronic LBP. Electronic supplementary material The online version of this article (doi:10.1007/s00586-010-1518-3) contains supplementary material, which is available to authorized users.

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An updated overview of clinical guidelines for the management of non-specific low back pain in primary care

Bart W. Koes, Maurits van Tulder, Chung-Wei Lin … (2010)

The aim of this study was to present and compare the content of (inter)national clinical guidelines for the management of low back pain. To rationalise the management of low back pain, evidence-based clinical guidelines have been issued in many countries. Given that the available scientific evidence is the same, irrespective of the country, one would expect these guidelines to include more or less similar recommendations regarding diagnosis and treatment. We updated a previous review that included clinical guidelines published up to and including the year 2000. Guidelines were included that met the following criteria: the target group consisted mainly of primary health care professionals, and the guideline was published in English, German, Finnish, Spanish, Norwegian, or Dutch. Only one guideline per country was included: the one most recently published. This updated review includes national clinical guidelines from 13 countries and 2 international clinical guidelines from Europe published from 2000 until 2008. The content of the guidelines appeared to be quite similar regarding the diagnostic classification (diagnostic triage) and the use of diagnostic and therapeutic interventions. Consistent features for acute low back pain were the early and gradual activation of patients, the discouragement of prescribed bed rest and the recognition of psychosocial factors as risk factors for chronicity. For chronic low back pain, consistent features included supervised exercises, cognitive behavioural therapy and multidisciplinary treatment. However, there are some discrepancies for recommendations regarding spinal manipulation and drug treatment for acute and chronic low back pain. The comparison of international clinical guidelines for the management of low back pain showed that diagnostic and therapeutic recommendations are generally similar. There are also some differences which may be due to a lack of strong evidence regarding these topics or due to differences in local health care systems. The implementation of these clinical guidelines remains a challenge for clinical practice and research.

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Author and article information

Contributors

Melinda Járomi: jaromi@etk.pte.hu

Brigitta Szilágyi: szbtadi.pte@tr.pte.hu

Anita Velényi: velenyi.anita@pte.hu

Eleonóra Leidecker: leidecker.eleonora@etk.pte.hu

Bence László Raposa: bence.raposa@etk.pte.hu

Márta Hock: hock.marta@etk.pte.hu

Petra Baumann: baumann.petra@pte.hu

Pongrác Ács: pongrac.acs@etk.pte.hu

Alexandra Makai:

ORCID: http://orcid.org/0000-0002-1907-120X

alexandra.makai@etk.pte.hu

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 23 April 2021

Publication date PMC-release: 23 April 2021

Publication date Collection: 2021

Volume: 21

Issue : Suppl 1 Issue sponsor : Publication costs were funded by the HRDOP-3.6.2-16-2017-00003, Cooperative Research Network in Economy of Sport, Recreation and Health; by the GINOP 2.3.2-15-2016-00047 grant and by the 20765/3/2018/FEKUTSTRAT grant. The articles have undergone the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.

Electronic Location Identifier: 1479

Affiliations

[1 ]GRID grid.9679.1, ISNI 0000 0001 0663 9479, Institute of Physiotherapy and Sports Science, Faculty of Health Sciences, , University of Pécs, ; Vörösmarty u. 3., Pécs, H-7621 Hungary

[2 ]GRID grid.9679.1, ISNI 0000 0001 0663 9479, Department of Neurosurgery, Clinical Center, , University of Pécs, ; Rét utca 2, Pécs, H-7623 Hungary

[3 ]GRID grid.9679.1, ISNI 0000 0001 0663 9479, Faculty of Health Sciences, , University of Pécs, ; Vörösmarty u. 4, Pécs, H-7621 Hungary

Author information

Alexandra Makai http://orcid.org/0000-0002-1907-120X

Article

Publisher ID: 9506

DOI: 10.1186/s12889-020-09506-7

PMC ID: 8063275

PubMed ID: 33892680

SO-VID: 004afbce-b04c-4f54-9310-9c3811327135

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 3 September 2020

Date accepted : 6 September 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100003549, Hungarian Scientific Research Fund;

Award ID: 20765/3/2018/FEKUTSTRAT grant

Award Recipient : Pongrác Ács

Custom metadata

ScienceOpen disciplines: Public health

Keywords: low back pain,health-related quality of life,short form health survey,roland morris disability questionnaire,social determinants

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ScienceOpen disciplines: Public health

Keywords: low back pain, health-related quality of life, short form health survey, roland morris disability questionnaire, social determinants

Assessment of health-related quality of life and patient’s knowledge in chronic non-specific low back pain

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Most cited references 36

A systematic review of low back pain cost of illness studies in the United States and internationally.

A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

An updated overview of clinical guidelines for the management of non-specific low back pain in primary care

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