A multisite longitudinal evaluation of patient characteristics associated with a poor response to non-surgical multidisc
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(2020) 21:807
RESEARCH ARTICLE
Open Access
A multisite longitudinal evaluation of patient characteristics associated with a poor response to non-surgical multidisciplinary management of low back pain in an advanced practice physiotherapist-led tertiary service Shaun O’Leary1,2* , Maree Raymer2, Peter Window2, Patrick Swete Kelly2, Darryl Lee2, Linda Garsden2, Rebecca Tweedy2, Ben Phillips3, Will O’Sullivan3, Anneke Wake3, Alison Smith4, Sheryl Pahor5, Luen Pearce5, Rod McLean5, David Thompson5, Erica Williams5, Damien Nolan5, Jody Anning5, Ian Seels6, Daniel Wickins7, Darryn Marks8,9, Brendan Diplock10, Vicki Parravicini10, Linda Parnwell10, Bill Vicenzino1, Tracy Comans11, Michelle Cottrell1,2, Asaduzzaman Khan1 and Steven McPhail12,13
Abstract Background: Non-surgical multidisciplinary management is often the first pathway of care for patients with chronic low back pain (LBP). This study explores if patient characteristics recorded at the initial service examination have an association with a poor response to this pathway of care in an advanced practice physiotherapist-led tertiary service. Methods: Two hundred and forty nine patients undergoing non-surgical multidisciplinary management for their LBP across 8 tertiary public hospitals in Queensland, Australia participated in this prospective longitudinal study. Generalised linear models (logistic family) examined the relationship between patient characteristics and a poor response at 6 months follow-up using a Global Rating of Change measure. Results: Overall 79 of the 178 (44%) patients completing the Global Rating of Change measure (28.5% loss to followup) reported a poor outcome. Patient characteristics retained in the final model associated with a poor response included lower Formal Education Level (ie did not complete school) (Odds Ratio (OR (95% confidence interval)) (2.67 (1.17–6.09), p = 0.02) and higher self-reported back disability (measured with the Oswestry Disability Index) (OR 1.33 (1.01–1.77) per 10/100 point score increase, p = 0.046). (Continued on next page)
* Correspondence: [email protected] 1 School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia 2 Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted us
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