The Effect of the Severity of Preoperative Back Pain on Patient Reported Outcomes, Recovery Ratios, and Patient Satisfaction Following MIS-TLIF

2021 ◽  
Author(s):  
Kevin C. Jacob ◽  
Madhav R. Patel ◽  
Alexander W. Parsons ◽  
Nisheka N. Vanjani ◽  
Hanna Pawlowski ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Back Pain ◽  
Patient Reported Outcomes ◽  
Patient Reported

Effect of a Waiting Room Communication Strategy on Imaging Rates and Awareness of Public Health Messages for Low Back Pain

2021 ◽  
Author(s):  
Sweekriti Sharma ◽  
Adrian C Traeger ◽  
Elise Tcharkhedian ◽  
Paul M Middleton ◽  
Louise Cullen ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Patient Satisfaction ◽  
Back Pain ◽  
Patient Reported Outcomes ◽  
Communication Strategies ◽  
Communication Strategy ◽  
Low Back ◽  
Waiting Room ◽  
Patient Reported ◽  
Campaign Messages

Abstract Background Few studies have investigated the effects of waiting room communication strategies on healthcare behavior. We aimed to determine the effect of a waiting room communication strategy, designed to raise awareness of potential harms of unnecessary imaging, on lumbar imaging rates in the Emergency Department (ED). Methods We conducted a controlled experimental study with BABA or ‘replicated time series’ design. Design included a 6-week run-in time. Following this there were alternating one-week intervention and control periods. The intervention group received a communication strategy describing the potential harms of unnecessary imaging for low back pain, shown on the same 55” screen as the standard messaging. The communication strategy was designed by a creative innovation agency and included five digital posters and a patient leaflet. The control group received standard messaging for the waiting room at the time, shown on a 55” LCD screen, and the patient leaflet. The primary outcome was the number and proportion of people presenting to ED with low back pain who received at least one lumbar imaging test, measured using routinely collected ED data. Secondary patient-reported outcomes (patient satisfaction, awarenesss of campaign messages) were collected from a sample of people presenting for any condition who responded to a text message-based survey. Results For the imaging outcome, 337 people presenting to ED with low back pain were included over a 4-month period (intervention n= 99; control n= 238). All had available data on lumbar imaging. Use of lumbar imaging was 25% in those exposed to the communication strategy (95% CI= 18% to 35%) compared with 29% in those exposed to the standard waiting room messaging (95% CI= 23% to 35%) (OR= 0.83; 95% CI= 0.49 to 1.41). For the patient-reported outcomes, 349 patients presenting to ED for any condition responded to the survey (intervention n=170; control n=179; response rate =33%). There was uncertain evidence that the intervention increased awareness of the communication strategy leaflet (OR= 2.00, 95% CI= 0.90 to 4.47). Other measures did not suggest between-group differences in patient satisfaction or awareness of the campaign messages. Conclusion A communication strategy displayed in the emergency department waiting room may slightly reduce the proportion of patients with low back pain who receive lumbar imaging; though there is uncertainty due to imprecision. The campaign did not appear to increase awareness of campaign messages or affect patient satisfaction in a sample of patients presenting to the ED for any reason. Larger studies should investigate whether simple, low-cost waiting room communication strategies can raise awareness of unnecessary healthcare and influence healthcare quality. Trial registration : ACTRN12620000300976, 05/03/2020

scholarly journals Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rabih Nayfe ◽  
Matthieu Chansard ◽  
Linda S. Hynan ◽  
Eric M. Mortensen ◽  
Thiru Annaswamy ◽  
...  
Keyword(s):  
Information System ◽  
Back Pain ◽  
Social Functioning ◽  
Patient Reported Outcomes ◽  
Discriminant Validity ◽  
Measurement Information ◽  
Outcomes Measurement ◽  
Convergent And Discriminant Validity ◽  
Patient Reported ◽  
Measurement Information System

Abstract Background Chronic low back pain (cLBP) results in significant physical, psycho-social and socioeconomic burden. Identifying efficient and reliable patient reported outcome measures is critical for research and clinical purposes. The NIH’s Patient Reported Outcomes Measurement Information System (PROMIS) instruments have not been compared to validated “legacy” instruments in older adults with cLBP. This study evaluates construct (convergent and discriminant) validity and time to complete (TTC) PROMIS as compared to legacy instruments. Methods We enrolled older Veterans (age 60+) with cLBP with/without leg pain scheduled for lumbar epidural steroid injections. Subjects completed PROMIS computer adaptive test item banks and corresponding legacy instruments in the following domains: pain intensity, interference, and behavior; functional status; depression and anxiety; fatigue; sleep and social functioning. Convergent and discriminant validity between PROMIS and legacy instruments was evaluated using Spearman rank order correlations; Mann-Whitney U tests compared TTC. Results Of the 71 Veterans recruited, the median (IQR) age was 67 (63–71) years old, 94% were men, 76% were White, 17% Black, and 96% were Non-Hispanic. Spearman correlations between PROMIS and legacy instruments showed moderate to very strong convergent validity in all domains (r = 0.4–1.0), except for social functioning and pain behavior (PROMIS Pain Behavior with Fear Avoidance Belief Questionnaire). The total median TTC for all PROMIS items was significantly shorter than legacy items, 8 min 50 s vs 29 min 14 s respectively, p < 0.001. Conclusions Given time efficiency of using PROMIS, along with strong construct validity, PROMIS instruments are a practical choice for measuring multidimensional PROs in older Veterans with cLBP for both research and clinical purposes.

scholarly journals Pharmacological target therapy of neuropathic pain and patient-reported outcomes in patients with chronic low back pain in Korea

Medicine ◽  
2018 ◽  
Vol 97 (35) ◽  
pp. e11919
Author(s):  
Jae Taek Hong ◽  
Jin-Hwan Kim ◽  
Keun-Su Kim ◽  
Chong-Suh Lee ◽  
Hyun-Chul Shin ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Patient Reported Outcomes ◽  
Target Therapy ◽  
Low Back ◽  
Patient Reported ◽  
Pharmacological Target

scholarly journals Postoperative satisfaction following lumbar spinal fusion surgery: patient expectation versus actuality

2019 ◽  
Vol 31 (5) ◽  
pp. 676-682 ◽  
Author(s):  
Joon S. Yoo ◽  
Dil V. Patel ◽  
Benjamin C. Mayo ◽  
Dustin H. Massel ◽  
Sailee S. Karmarkar ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Back Pain ◽  
Minimally Invasive ◽  
Outcome Measures ◽  
Lumbar Fusion ◽  
Leg Pain ◽  
Strong Correlations ◽  
Patient Reported ◽  
Preoperative Expectation ◽  
Postoperative Symptoms

OBJECTIVEDue to the reported benefits associated with minimally invasive spine surgery (MIS), patients seeking out minimally invasive surgery may have higher expectations regarding their outcomes. In this study the authors aimed to assess the effects of preoperative expectations and postoperative outcome actuality, and the difference between the two, on postoperative satisfaction following MIS for lumbar fusion procedures.METHODSPatients scheduled for either a 1- or 2-level lumbar fusion MIS were administered confidential surveys preoperatively and at 6 months postoperatively. The surveys administered preoperatively consisted of 2 parts: preoperative patient-reported outcomes (PROs), including the Oswestry Disability Index (ODI), visual analog scale (VAS) back pain, and VAS leg pain, and expected postoperative PROs. The surveys administered 6 months postoperatively consisted of 2 parts: postoperative PROs and satisfaction. Preoperative symptoms, expected postoperative symptoms, and actual postoperative symptoms were compared using paired t-tests. Pearson correlation was used to compare the association between 1) postoperative change in PROs and satisfaction, 2) expectation and satisfaction, 3) expectation-actuality discrepancy and satisfaction, and 4) actuality and satisfaction.RESULTSIn total, 101 patients completed all surveys. Patients expected to improve in all PROs from baseline, except for ODI personal care, in which they expected to get worse after surgery. In actuality, patients improved in all PROs from baseline, except for ODI personal care, in which they did not demonstrate improvement or worsening. Patients did not surpass any expectations regarding PRO improvement. The association between patient satisfaction and postoperative change was strong for the VAS back pain score, while ODI and VAS leg pain scores showed moderate correlations. Preoperative expectation and postoperative satisfaction demonstrated weak to moderate correlations for all outcome measures. All 3 PROs demonstrated moderate correlation between patient satisfaction and the expectation-actuality discrepancy. All 3 PROs demonstrated strong correlations between satisfaction and actual postoperative outcomes, with ODI having the strongest correlation.CONCLUSIONSIn this observational study, the authors determined that the actual postoperative results following surgery were strongly correlated with patient satisfaction, while the patients’ expectation, the expectation-actuality discrepancy, and the postoperative improvement did not demonstrate strong correlations for all patient-reported outcome measures utilized in this study. The investigation results suggest that the most important indicator of how satisfied patients feel following surgery may be the actual outcome itself, rather than the preoperative expectation or the degree to which the expected result was met.

scholarly journals Patient-Reported Outcomes and Satisfaction after Cervical Epidural Steroid Injection for Cervical Radiculopathy

2019 ◽  
Vol 8 ◽  
Author(s):  
Masoud Hashemi ◽  
Payman Dadkhah ◽  
Mehrdad Taheri ◽  
Mahshid Ghasemi ◽  
Ali Hosseinpoor ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Patient Reported Outcomes ◽  
Steroid Injection ◽  
Cervical Radiculopathy ◽  
Epidural Steroid Injection ◽  
Patient Reported ◽  
The Mean ◽  
Epidural Steroid

Background: Cervical radiculopathy caused by disc herniation is a frequent public health issue with economical and socio-professional impacts. The objective of the present study is to evaluate the patient-reported outcomes and satisfaction from cervical epidural steroid injection during a 2-year follow-up. Materials and Methods: Results based on patients’ reports from a previously performed intervention of cervical epidural steroid injection on patients with cervical radiculopathy due to cervical disc herniation are prospectively collected. Outcome measures are Neck Disability Index (NDI), numerical rating scale (NRS) for pain assessment, and 5-scale patient satisfaction questionnaire (PSQ) plus opioid medication for pain relief, additional injections, and progression to surgery. Results: Of total 37 cases, 34 were available for follow-up after 2-year postoperatively. The mean preoperative NDI was 21.17 and improved to 17.38, and the mean NRS was 7.7 and improved to 5.00; both were statistically significant. Mean patient satisfaction after 2 years was 3.17 out of 5. 11 cases needed additional injections, and 4 of patients proceeded to surgery. Conclusion: We showed that transforaminal cervical epidural steroid injection for cervical radiculopathy is an effective non-surgical treatment option, providing significant pain relief and functional improvement during 2-years follow-up along with higher-than-average patient satisfaction in most of our patients. [GMJ.2019;8:e1478]

scholarly journals Prevalence of Neuropathic Pain and Patient-Reported Outcomes in Korean Adults with Chronic Low Back Pain Resulting from Neuropathic Low Back Pain

2017 ◽  
Vol 11 (6) ◽  
pp. 917-927 ◽  
Author(s):  
Jin-Hwan Kim ◽  
Jae Taek Hong ◽  
Chong-Suh Lee ◽  
Keun-Su Kim ◽  
Kyung-Soo Suk ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Linear Regression ◽  
Chronic Low Back Pain ◽  
Patient Reported Outcomes ◽  
Functional Disability ◽  
Low Back ◽  
Patient Reported ◽  
Eq Vas

<sec><title>Study Design</title><p>A noninterventional, multicenter, cross-sectional study.</p></sec><sec><title>Purpose</title><p>We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP).</p></sec><sec><title>Overview of Literature</title><p>Among patients with CLBP, 20%–55% had NP.</p></sec><sec><title>Methods</title><p>Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4&lt;4) groups.</p></sec><sec><title>Results</title><p>A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; <italic>p</italic>&lt;0.01), in patients who had pain based on radiological and neurological findings (59.0%; <italic>p</italic>&lt;0.01), and in patients who had severe pain (49.0%; <italic>p</italic>&lt;0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; <italic>p</italic>&lt;0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; <italic>p</italic>&lt;0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; <italic>p</italic>&lt;0.01) and higher QBPDS (β=7.0; <italic>p</italic>&lt;0.01) scores than those without NP.</p></sec><sec><title>Conclusions</title><p>NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.</p></sec>

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