Minimal Intervention of Patient Education for Low Back Pain: A Systematic Review with Meta-Analysis.

Gomes, Luís A; Rodrigues, Ana M; Windt, Danielle; Pires, Diogo; Afreixo, Vera; Canhão, Helena; Cruz, Eduardo B

Abstract

To explore the effects of minimal intervention of patient education (MIPE) for reducing disability and pain intensity in patients with low back pain (LBP). Intervention systematic review with meta-analysis of randomized controlled trials. We searched the MEDLINE, Embase, CENTRAL, CINAHL, and PsycINFO databases from inception to May 2023. Trials comparing MIPE, consisting of a single session of patient education, to no or other interventions in patients with LBP. Random effects meta-analysis was conducted where possible. A non-inferiority margin of 5 points (0-100 scale) was considered for non-inferiority hypotheses. We assessed risk of bias using the revised Cochrane risk-of-bias tool (RoB2), and certainty of evidence using the Grading of Recommendations Assessment, Development Evaluation (GRADE) framework. A total of 21 trials were included. There were no differences between MIPE and no effects on disability and pain intensity. There was low certainty evidence that MIPE had inferior effects on short-term disability (mean difference=3.62 [95%CI 0.85, 6.38], 15 trials, n=3 066, I =75%) and pain intensity (mean difference=9.43 [95%CI 1.31, 17.56], 10 trials, n=1 394; I =90%) than other interventions. No differences were found for subsequent timepoints. As an intervention delivered in isolation, and without tailoring (ie, one-size-fits-all intervention), MIPE on average did not provide benefits for reducing disability and pain intensity over no or other interventions. We encourage clinicians to consider using additional/other or more tailored treatments when helping people manage LBP.

Citation

Gomes, L. A., Rodrigues, A. M., Windt, D., Pires, D., Afreixo, V., Canhão, H., & Cruz, E. B. (in press). Minimal Intervention of Patient Education for Low Back Pain: A Systematic Review with Meta-Analysis. Journal of Orthopaedic & Sports Physical Therapy, 1-39. https://doi.org/10.2519/jospt.2023.11865

• Journal Article Type: Article
• Acceptance Date: Nov 15, 2023
• Online Publication Date: Nov 16, 2023
• Deposit Date: Dec 4, 2023
• Journal: The Journal of orthopaedic and sports physical therapy
• Print ISSN: 0190-6011
• Publisher: Journal of Orthopaedic and Sports Physical Therapy
• Peer Reviewed: Peer Reviewed
• Pages: 1-39
• DOI: https://doi.org/10.2519/jospt.2023.11865
• Keywords: Meta-analysis, Low back pain, Disability, Systematic review, Patient education, Pain intensity