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Open Access 22-11-2023

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured and Standardized Education or Advice for Chronic Primary low back pain in Adults

Authors: Danielle Southerst, Cesar A. Hincapié, Hainan Yu, Leslie Verville, André Bussières, Douglas P. Gross, Paulo Pereira, Silvano Mior, Andrea C. Tricco, Christine Cedraschi, Ginny Brunton, Margareta Nordin, Jessica J. Wong, Gaelan Connell, Heather M. Shearer, Astrid DeSouza, Javier Muñoz Laguna, Joyce G. B. Lee, Daphne To, Rahim Lalji, Kent Stuber, Martha Funabashi, Léonie Hofstetter, Danny Myrtos, Andrew Romanelli, Brett Guist, James J. Young, Sophia da Silva-Oolup, Maja Stupar, Dan Wang, Kent Murnaghan, Carol Cancelliere

Published in: Journal of Occupational Rehabilitation | Issue 4/2023

Abstract

Purpose

Evaluate benefits and harms of education/advice for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline.

Methods

Electronic databases were searched for randomized controlled trials (RCTs) assessing education/advice compared with placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of education/advice could be isolated). We conducted meta-analyses and graded the certainty of evidence.

Results

We screened 2514 citations and 86 full text RCTs and included 15 RCTs. Most outcomes were assessed 3 to 6 months post-intervention. Compared with no intervention, education/advice improved pain (10 RCTs, MD = -1.1, 95% CI -1.63 to -0.56), function (10 RCTs, SMD = -0.51, 95% CI -0.89 to -0.12), physical health-related quality of life (HRQoL) (2 RCTs, MD = 24.27, 95% CI 12.93 to 35.61), fear avoidance (5 RCTs, SMD = -1.4, 95% CI -2.51 to -0.29), depression (1 RCT; MD = 2.10, 95% CI 1.05 to 3.15), and self-efficacy (1 RCT; MD = 4.4, 95% CI 2.77 to 6.03). Education/advice conferred less benefit than sham Kinesio taping for improving fear avoidance regarding physical activity (1 RCT, MD = 5.41, 95% CI 0.28 to 10.54). Compared with usual care, education/advice improved pain (1 RCT, MD = -2.10, 95% CI -3.13 to -1.07) and function (1 RCT, MD = -7.80, 95% CI -14.28 to -1.32). There was little or no difference between education/advice and comparisons for other outcomes. For all outcomes, the certainty of evidence was very low.

Conclusion

Education/advice in adults with CPLBP was associated with improvements in pain, function, HRQoL, and psychological outcomes, but with very low certainty.

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Title: Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured and Standardized Education or Advice for Chronic Primary low back pain in Adults
Authors: Danielle Southerst
Cesar A. Hincapié
Hainan Yu
Leslie Verville
André Bussières
Douglas P. Gross
Paulo Pereira
Silvano Mior
Andrea C. Tricco
Christine Cedraschi
Ginny Brunton
Margareta Nordin
Jessica J. Wong
Gaelan Connell
Heather M. Shearer
Astrid DeSouza
Javier Muñoz Laguna
Joyce G. B. Lee
Daphne To
Rahim Lalji
Kent Stuber
Martha Funabashi
Léonie Hofstetter
Danny Myrtos
Andrew Romanelli
Brett Guist
James J. Young
Sophia da Silva-Oolup
Maja Stupar
Dan Wang
Kent Murnaghan
Carol Cancelliere
Publication date: 22-11-2023
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 4/2023
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-023-10120-8

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Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured and Standardized Education or Advice for Chronic Primary low back pain in Adults

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

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Abstract

Purpose

Methods

Results

Conclusion

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