Background Low back pain (LBP) is very common. Being one of the most common presenting complaints for doctor visits, in the Global Burden of Disease study, it was ranked highest in terms of causing disability, and 6th in terms of overall burden, despite current available guidelines to manage LBP [1,2]. As optimal management requires coordination with patient expectations, understanding the consumer's perceived health information needs is important to optimize health outcomes for LBP.
Objectives To identify consumer perceived health information needs regarding LBP.
Methods A comprehensive search of MEDLINE, EMBASE, CINAHL and PsycINFO was performed (1990 to December 2014). Core search terms were developed around consumers' perspective of needs relating to health information relating to LBP. Data regarding design and methodology were extracted. Emergent themes were identified to provide a systematic review of the existing literature.
Results 2638 papers were identified, of which 37 articles were relevant (Fig 1); 33 used qualitative methods, 7 used quantitative methods, and 3 used mixed methods. Participants, mainly with chronic LBP, were mostly recruited from primary practice but also from pain clinics, hospital, rehabilitation centers, specialist spine clinics and the general public. The quality of the literature was variable, with few studies specifically addressing the review question. However, many results were consistent. The 2 major areas of need, identified in at least 2 studies, related to
1) Information content: Consumers wanted general information about LBP to better understand it, with emphasis on obtaining a specific diagnosis and cause for LBP, which underscored the perceived need for imaging to acquire a diagnosis. Patients also wanted information regarding prognosis, including future disability and effect on work capacity, potential precipitation of flares. General information on LBP management, including pharmacological and non-pharmacological strategies, pain management, flare management and prevention, self-management strategies and support services for LBP were desired. They valued individualized information that did not conflict with their lived experience, life goals and beliefs.
2) Information delivery: Patients valued high quality information that was valid and trustworthy. Information needed to be delivered in a suitable tone and in understandable language, without medical jargon. They wanted to know how to find information about LBP.
Conclusions This review highlights the mismatch between consumer health information needs and current health care providers' management. Widespread community wide interventions may be required to address community beliefs and expectations about back pain in order to improve consumer understanding of LBP. Addressing consumer perceived needs more effectively and integrating this into the management of LBP may improve patient outcomes regarding LBP.
Hoy, D., et al., The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases, 2014. 73(6): p. 968–974.
Australian Institute of Health and Welfare. Back pain and problems. 2015 [cited 2016 17 January]; Available from: http://www.aihw.gov.au/back-problems/.
Acknowledgement This work was supported by Arthritis and Osteoporosis Victoria.
A.Wluka is the recipient of an NHMRC Career Development Fellowship (Clinical level 2)
Disclosure of Interest None declared