Original ArticleChronic Disease Self-Management Program for Low Back Pain in the Elderly
Section snippets
Design
This study was a prospective, parallel-groups, randomized controlled trial (Fig 1). Participants were randomized to receive the workshop immediately (intervention group) or wait for 6 months (control group) using an equal allocation algorithm stratified by race.26 Group allocation was concealed from study personnel interacting with participants before randomization. The original goal was to randomize 100 African Americans and 100 whites and conduct separate analyses for each racial category.
Results
From September 2002 through June 2003, 120 seniors were randomized (Fig 1): 60 to the program and 60 to the wait-list. Immediately after randomization, 11 participants refused allocation to the control group, leaving a total of 109 participants enrolled in the trial.
The 11 refused enrollment on the grounds that 6 months was too long to wait, some putting the wait in context of their life expectancy. These 11 had similar characteristics to the study control group (Table 1): 91% women, mean age
Discussion
Self-care, including patient education about healthy behaviors, is increasingly viewed as a critical ingredient of comprehensive and appropriate health care services.36, 37 There is considerable evidence to suggest that the adoption of healthy behaviors by patients is a necessary component in the management of functional conditions.38 Further, personal beliefs have been linked to the adoption of healthy behaviors8, 39, 40, 41, 42, 43 which are integral to the successful management of functional
Conclusion
There was no advantage for the CDSMP over a wait-list control for improving pain (primary outcome), general health, self-efficacy, and certain self-care attitudes in older Americans with chronic LBP. However, a benefit was suggested for functional disability, days with disability, emotional well-being, and fatigue.
Acknowledgements
The authors wish to thank their lay leaders for facilitating the CDSMP classes and assisting with recruitment. The authors also wish to thank Lester Partner, DC, and David Corll, DC, for raising interest in the program through their public lectures on health care. Mr Emerson Barr was responsible for conducting the follow-up telephone interviews.
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2021, Musculoskeletal Science and PracticeCitation Excerpt :In total, 09 RCTs were eligible and recruited 1866 participants (Table 1). Trials had recruited study participants from the community (Buhrman et al., 2004; Irvine et al., 2015; Haas et al., 2005; Zadro et al., 2019), primary care, hospitals and healthcare settings (Johnson et al., 2007; Von Korff et al., 1998, 2005), through employers (Shebib et al., 2019) and healthcare workers from hospitals (Chaleat-Valayer et al., 2016). All included studies (Buhrman et al., 2004; Chaleat-Valayer et al., 2016; Irvine et al., 2015; Johnson et al., 2007; Haas et al., 2005; Von Korff et al., 1998, 2005; Shebib et al., 2019; Zadro et al., 2019) reported broadly similar content in their control interventions across the trials.
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2019, Physiotherapy (United Kingdom)Citation Excerpt :The search strategy retrieved 5541 studies. After the selection process (Fig. 1), 18 randomised controlled trials [32–49] (reference list present as a Supplement) with a pooled sample size of 1857 participants (mean sample size = 107.16, SD = 72.85) were considered eligible for data analysis. Most of the eligible studies described that older people with chronic symptoms (>3 months) were the targeted population.
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2018, Patient Education and CounselingCitation Excerpt :This scale has acceptable internal consistency (Cronbach’s α 0.82–0.91) and been widely used in patients with osteoarthritis [52]. Self-Efficacy Scale (SES) was utilised in three included studies [28,34,42]. This 11-item scale was developed by using pain and other symptoms subscales of the original ASES.
Sources of support: Funding was provided through a grant from the Health Resources and Services Administration, US Department of Health and Human Services (R18 HP10012).