Patient expectations as predictors of outcome in patients with acute low back pain.

Patient expectations as predictors of outcome in patients with acute low back pain. Research Abstract Details 

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Patient expectations as predictors of outcome in patients with acute low back pain. Abstract Text:

Samuel S Myers,Russell S Phillips,Roger B Davis,Daniel C Cherkin,Anna Legedza,Ted J Kaptchuk,Andrea Hrbek,Julie E Buring,Diana Post,Maureen T Connelly,David M Eisenberg,Samuel S Myers,Russell S Phillips,Roger B Davis,Daniel C Cherkin,Anna Legedza,Ted J Kaptchuk,Andrea Hrbek,Julie E Buring,Diana Post,Maureen T Connelly,David M Eisenberg,Samuel S Myers,Russell S Phillips,Roger B Davis,Daniel C Cherkin,Anna Legedza,Ted J Kaptchuk,Andrea Hrbek,Julie E Buring,Diana Post,Maureen T Connelly,David M Eisenberg,

BACKGROUND: Few studies have evaluated the association between patient expectations for recovery and clinical outcomes, and no study has evaluated whether asking patients to choose their therapy modifies such an association. OBJECTIVE: To evaluate the association between patients' expectations and functional recovery in patients with acute low back pain (LBP), and to determine whether that association is affected by giving patients choice of therapy. DESIGN AND PARTICIPANTS: A secondary analysis of a randomized controlled trial comparing usual care alone to usual care plus choice of chiropractic, acupuncture, or massage in 444 adults with acute LBP, lasting less than 21 days. MEASUREMENTS AND MAIN RESULTS: Primary outcome was functional disability (Roland score) at 5 and 12 weeks. Patients' general expectations for improvement were associated with improvement in functional status (beta = 0.96, 95% CI = 0.56, 1.36). A 1-point increase in general expectations was associated with a 0.96-point improvement in Roland score. The association of expectation with outcome was 2-3 times greater in the usual care group than the choice group. However, these differences did not reach statistical significance. CONCLUSIONS: In patients with acute LBP, higher expectations for recovery are associated with greater functional improvement. Eliciting patient expectations for improvement may be a simple way to identify patients with the highest (or lowest) likelihood of experiencing functional improvement. Incorporating questions about patient expectations in future trials may clarify the role of this important correlate of clinical outcomes.

Patient expectations as predictors of outcome in patients with acute low back pain. Publishing Authors By Initials

SS Myers,RS Phillips,RB Davis,DC Cherkin,A Legedza,TJ Kaptchuk,A Hrbek,JE Buring,D Post,MT Connelly,DM Eisenberg,SS Myers,RS Phillips,RB Davis,DC Cherkin,A Legedza,TJ Kaptchuk,A Hrbek,JE Buring,D Post,MT Connelly,DM Eisenberg,SS Myers,RS Phillips,RB Davis,DC Cherkin,A Legedza,TJ Kaptchuk,A Hrbek,JE Buring,D Post,MT Connelly,DM Eisenberg,

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Patient expectations as predictors of outcome in patients with acute low back pain. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of general internal medicine : official jo

VOLUME: 23

Page Numbers: 148-53

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ISSN: 1525-1497

DAY: 8

MONTH: 12

YEAR: 2007

Patient expectations as predictors of outcome in patients with acute low back pain. Information

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LANGUAGE: eng

NlmUniqueID: 8605834

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AFFILIATION: Department of Medicine, Harvard Medical School, Mount Auburn Hospital, Cambridge, MA, USA, Sam_Myers@hms.harvard.edu.

Country: United States

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MEDLINETA: J Gen Intern Med

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