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Lower baseline disability and participants’ not claiming workers’ compensation were found to be the factors responsible for patients’ nonadherence to the recommended regimen.
Acute low back pain refers to pain condition that prevails for 6 to 12 weeks between the coastal angles and gluteal folds radiating down one or both legs (sciatica). It is often nonspecific; hence its cause remains unknown. Jasper D.Bier et al. conducted a study that aims to evaluate the extent of patient-reported nonadherence with the guideline-recommended care for acute low back pain. The study design involved a secondary analysis of data from participants recruited in the Paracetamol for Acute Low Back Pain study trial.
A total of 1643 participants with acute low back pain was included and the interventions comprised of guideline-recommended care consisting of reassurance, simple analgesia, the advice to stay active and avoid bed rest and advice against additional treatments and referral for imaging. The primary outcome measures were a proportion of patients that develop nonadherence with guideline-recommended care. Nonadherence was explained as; (1) failure to consume the advised paracetamol dose, or (2) receipt of additional health care, tests, or medication during the trial treatment period (4wk).
Multivariable logistic regression analysis evaluated the factors associated with nonadherence. The results showed that about 39.7% of participants were nonadherent in the first week of treatment. After the 4-week treatment period, the percentage of nonadherent patients increased to 70.0%, About 57.5% did not complete the advised paracetamol regimen. The various factors related to nonadherence were a higher perceived risk of persistent pain, lower level of disability, and not claiming workers' compensation with odds ratios ranging from .46 to 1.05. It was concluded that adherence to guideline-recommended care for acute low back pain was poor. A small proportion of participants completed the advised paracetamol regimen.
Arch Phys Med Rehabil. 2017 Jul 6. pii: S0003-9993(17)30451-3.
Patient non-adherence to guideline-recommended care in acute low back pain
Jasper D. Bier et al.
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