Evaluation of individualized quality of life and illness perceptions in low back pain. A patient education cluster randomized controlled trial

Objective: To evaluate the effect of a cognitive patient education intervention compared with usual care on secondary outcomes of individual quality of life and psychological outcomes of illness perceptions and pain catastrophizing in patients with low back pain. Methods: A pragmatic cluster randomized controlled trial in which 16 general practitioners (GPs) and 20 physiotherapists (PTs) in primary care were randomly assigned to provide either a cognitive patient education intervention or usual treatment. Patients were followed up at 4 weeks and 12 months after treatment. Linear mixed models were used with group, time, type of clinician and interaction effects of group* time as fixed effects. Results: A total of 203 patients provided data at baseline, 86% responded at 4 weeks and 74% at 12 months. For all the outcome measures there was a statistically significant effect of time (p < 0.001) and type of clinician (p < 0.05) during the follow-up year. There was a significant interaction effect of group x time on illness perceptions (p = 0.003), however not for the other outcome measures. Conclusion: The cognitive patient education intervention initiated a faster improvement in illness perceptions but not in the other outcomes. Practice implications: A patient education intervention can be beneficial to improve illness perceptions, however more research is needed. (C) 2016 Published by Elsevier Ireland Ltd.