Skip to main content
Article thumbnail
Location of Repository

The back home trial: general practitioner-supported leaflets may change back pain behavior

By Lisa Roberts, Paul Little, Judith Chapman, Ted Cantrell, Ruth Pickering and John Langridge


Study Design: a single-blind randomized controlled trial of a leaflet developed for people with acute low back pain was compared with the usual general practitioner management of back pain.<br/><br/>Objective: to test the effectiveness of a patient information leaflet on knowledge, attitude, behavior, and function.<br/><br/>Summary of Background Data: despite the commonality of back pain in general practice, little evidence on the effectiveness of simple interventions such as leaflets and advice on self-management has been reported. On the basis of a five-stage needs analysis, a simple leaflet was developed that considered the views of patients and health professionals.<br/><br/>Methods: for this study, 64 patients with acute back pain were assigned to the leaflet or control group. The participants were visited at home after 2 days, 2 weeks, then 3, 6, and 12 months, where they completed a range of self-report measures. Behavioral aspects were discreetly recorded by a "blinded" researcher. Primary outcomes were knowledge, attitude, behavior, and function.<br/><br/>Results: in all, 272 home visits were undertaken. The findings show that at 2 weeks, knowledge about sitting posture was greater in the leaflet group (P = 0.006), which transferred to a behavioral difference (sitting with lumbar lordosis support) when participants were unaware that they were being observed (P = 0.009). This difference remained significant at 3 months. Patients in the leaflet group also were better at maintaining a wide base of support when lifting a light object than the control subjects throughout all five assessments. There were no significant differences in the functional outcomes tested.<br/><br/>Conclusions: this trial demonstrates that written advice for patients can be a contributory factor in the initial general practitioner consultation because it may change aspects of knowledge and behavior. This has implications for the management of acute back pain, with potential health gain.<br/><br/

Topics: RC0321, RA
Year: 2002
OAI identifier:
Provided by: e-Prints Soton

Suggested articles


  1. A controlled trial of an educational pamphlet to prevent disability after occupational low back injury.
  2. (1983). A study of the natural history of back pain: Part 1. Development of a reliable and sensitive measure of disability in low back pain. Spine
  3. (1994). Address reprint requests to Lisa Roberts, PhD,
  4. (1995). Back pain: Lessons from patient education. Patient Educ Counseling
  5. Comparison study of the effectiveness of two methods of back education: A pilot study.NZJPhysiother 1991;19:32–9.
  6. (1988). Compliance for low back pain patients in the emergency department: A randomized trial.
  7. (1999). Control Issues and Low Back Pain. Unpublished thesis.
  8. Developing a valid and reliable measure of health outcome for patients with low back pain.
  9. (1984). Development of scales to measure perceived control of diabetes mellitus and diabetes-related health beliefs. Diabet Med
  10. (1978). Development of the multidimensional health locus of control scales. Health Educ Monogr
  11. (1994). Electrotherapy Explained. Principles and Practice. 2nd ed.
  12. (1996). Heat and cold: Conduction methods.
  13. (1999). Information and advice to patients with back pain can have a positive effect. Spine
  14. (1992). Information leaflets in the dermatology out-patient waiting area.
  15. (1993). Joint replacement and patient education. Int Orthop
  16. (1989). Overview of patient education: Opportunities and challenges for the twenty-first century. Nurs Clin North Am
  17. (1997). Physiotherapy health education literature.
  18. (1996). Pitfalls of patient education: Limited success of a program for back pain in primary care.
  19. (1996). Point of view.
  20. (1989). Randomized controlled trial of an educational booklet for patients presenting with back pain in general practice.
  21. Rethinking patient education.
  22. (1995). Seeking medical care in response to symptoms and life stress. Psychosom Med
  23. Should we give detailed advice and information booklets to patients with back pain? A randomized controlled factorial trial of a self-management booklet and doctor advice to take exercise for back pain.
  24. (1992). The 6-Item Short Form of the State Scale of the Spielberger State-Trait Anxiety Inventory.
  25. (1993). The impact of physician attitudes on patient satisfaction for low back pain. Arch Family Med
  26. (1976). The lumbar spine: An orthopaedic challenge. Spine
  27. (1975). The McGill Pain Questionnaire: Major properties and scoring methods.
  28. (1995). Written patient information: A review of the literature.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.