In the first systematic review , the patients ' or HCPs ' overall judgment about the likely evolution of LBP was the factor most strongly linked to poor outcome , with predictive validity similar to that of multidimensional scales .
This result may be explained by the implicit aggregation of many prognostic factors underlying this judgment and suggests the relevance of considering the patients from biopsychosocial and longitudinal points of view .
It is unlikely that any intervention focusing on a single factor would ever fit the needs of most patients ; interventions targeting determinants from several fields ( mainly psychosocial , biomechanical , and occupational ) may be more relevant .
Finally , in the third study , the prevalence of psychosocial comorbidity in chronic LBP patients was not found to be significantly higher than in other patients consulting in primary care .
Rather than specifically screening for psychosocial conditions , this suggests taking into account any potential comorbidity in patients with chronic LBP , as in other patients .
As this condition is illustrative of many situations encountered in primary care , the strategies proposed here may benefit most patients consulting in this setting
Non-specific low back pain ( LBP ) affects many people and has major socio-economic consequences .
Traditional therapeutic strategies , mainly focused on biomechanical factors , have had moderate and short-term impact .
Certain psychosocial factors have been linked to poor prognosis of LBP and they are increasingly considered as promising targets for management of LBP .
Primary health care providers ( HCPs ) are involved in most of the management of people with LBP and they are skilled in providing comprehensive care , including consideration of psychosocial dimensions .
This review aims to discuss three pieces of recent research focusing on psychosocial issues in LBP patients in primary care .
Economic Evaluation of an Intensive Group Training Protocol Compared With Usual Care Physiotherapy in Patients With Chronic Low Back Pain
Study Design . Economic evaluation from a societal perspective conducted alongside a r and omized controlled trial with a follow-up of 52 weeks . Objective . To evaluate the cost effectiveness and cost utility of an intensive group training protocol compared with usual care physiotherapy in patients with nonspecific chronic low back pain . The intensive group training protocol combines exercise therapy , back school , and behavioral principles . Summary of Background Data . Two studies found a significant reduction in absenteeism for a grade d activity program in occupational health care . This program has not yet been evaluated in a primary care physiotherapy setting . Methods . Participating physical therapists in primary care recruited 114 patients with chronic nonspecific low back pain . Eligible patients were r and omized to either the protocol group or the guideline group . Outcome measures included functional status ( Rol and Morris Disability Question naire ) , pain intensity ( 11-point numerical rating scale ) , general perceived effect and quality of life ( EuroQol-5D ) . Cost data were measured with cost diaries and included direct and indirect costs related to low back pain . Results . After 52 weeks , the direct health care costs were significantly higher for patients in the protocol group , largely due to the costs of the intervention . The mean difference in total costs amounted to & OV0556 ; 233 ( 95 % confidence interval : & OV0556 ; −2.185 ; & OV0556 ; 2.764 ) . The cost-effectiveness planes indicated no significant differences in cost effectiveness between the 2 groups . Conclusion . The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group . The differences in effects were small and not statistically significant . At present , national implementation of the protocol is not recommended
In the first systematic review , the patients ' or HCPs ' overall judgment about the likely evolution of LBP was the factor most strongly linked to poor outcome , with predictive validity similar to that of multidimensional scales .
This result may be explained by the implicit aggregation of many prognostic factors underlying this judgment and suggests the relevance of considering the patients from biopsychosocial and longitudinal points of view .
It is unlikely that any intervention focusing on a single factor would ever fit the needs of most patients ; interventions targeting determinants from several fields ( mainly psychosocial , biomechanical , and occupational ) may be more relevant .
Finally , in the third study , the prevalence of psychosocial comorbidity in chronic LBP patients was not found to be significantly higher than in other patients consulting in primary care .
Rather than specifically screening for psychosocial conditions , this suggests taking into account any potential comorbidity in patients with chronic LBP , as in other patients .
As this condition is illustrative of many situations encountered in primary care , the strategies proposed here may benefit most patients consulting in this setting
Non-specific low back pain ( LBP ) affects many people and has major socio-economic consequences .
Traditional therapeutic strategies , mainly focused on biomechanical factors , have had moderate and short-term impact .
Certain psychosocial factors have been linked to poor prognosis of LBP and they are increasingly considered as promising targets for management of LBP .
Primary health care providers ( HCPs ) are involved in most of the management of people with LBP and they are skilled in providing comprehensive care , including consideration of psychosocial dimensions .
This review aims to discuss three pieces of recent research focusing on psychosocial issues in LBP patients in primary care .