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Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study

INTRODUCTION: Low back pain (LBP) is a common reason for adults to seek medical care and is associated with important functional limitation and patient burden. Yet, heterogeneity in the causes and presentation of LBP and a lack of standardization in its management impede effective prevention and tre...

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Autores principales: Varrassi, Giustino, Moretti, Biagio, Pace, Maria Caterina, Evangelista, Paolo, Iolascon, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119580/
https://www.ncbi.nlm.nih.gov/pubmed/33713307
http://dx.doi.org/10.1007/s40122-021-00249-w
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author Varrassi, Giustino
Moretti, Biagio
Pace, Maria Caterina
Evangelista, Paolo
Iolascon, Giovanni
author_facet Varrassi, Giustino
Moretti, Biagio
Pace, Maria Caterina
Evangelista, Paolo
Iolascon, Giovanni
author_sort Varrassi, Giustino
collection PubMed
description INTRODUCTION: Low back pain (LBP) is a common reason for adults to seek medical care and is associated with important functional limitation and patient burden. Yet, heterogeneity in the causes and presentation of LBP and a lack of standardization in its management impede effective prevention and treatment. METHODS: We conducted a modified Delphi study to generate consensus statements for the diagnosis, management, and prognosis of LBP. A panel of five experts proposed 19 statements that were subsequently evaluated by physicians who treat LBP in their everyday clinical practice. Physicians were asked to validate statements in the form of a web survey assessing level of agreement on a five-point Likert-like scale. RESULTS: Consensus (≥ 70% agreement) was obtained for all 19 statements. Strength of agreement and physician comments highlighted the importance of pain management, but also strategies to ameliorate functional limitation and prevent future LBP episodes. Respondents favored multidisciplinary approaches and multimodal management for LBP, although there was some ambiguity as to how multidisciplinary strategies could be feasibly incorporated into daily practice. Finally, the results indicated some conflict regarding the use of imaging for the diagnosis of LBP and how to classify LBP for targeted treatment. CONCLUSION: The results of this study provide a summary of favored clinical practice for the management of chronic LBP. While the consensus statements were generally agreeable to survey respondents, some areas of ambiguity, including how to increase the feasibility of multidisciplinary strategies, when and how to use diagnostic imaging in LBP, and LBP classification, necessitate clarification in future studies and guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40122-021-00249-w.
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spelling pubmed-81195802021-05-14 Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study Varrassi, Giustino Moretti, Biagio Pace, Maria Caterina Evangelista, Paolo Iolascon, Giovanni Pain Ther Original Research INTRODUCTION: Low back pain (LBP) is a common reason for adults to seek medical care and is associated with important functional limitation and patient burden. Yet, heterogeneity in the causes and presentation of LBP and a lack of standardization in its management impede effective prevention and treatment. METHODS: We conducted a modified Delphi study to generate consensus statements for the diagnosis, management, and prognosis of LBP. A panel of five experts proposed 19 statements that were subsequently evaluated by physicians who treat LBP in their everyday clinical practice. Physicians were asked to validate statements in the form of a web survey assessing level of agreement on a five-point Likert-like scale. RESULTS: Consensus (≥ 70% agreement) was obtained for all 19 statements. Strength of agreement and physician comments highlighted the importance of pain management, but also strategies to ameliorate functional limitation and prevent future LBP episodes. Respondents favored multidisciplinary approaches and multimodal management for LBP, although there was some ambiguity as to how multidisciplinary strategies could be feasibly incorporated into daily practice. Finally, the results indicated some conflict regarding the use of imaging for the diagnosis of LBP and how to classify LBP for targeted treatment. CONCLUSION: The results of this study provide a summary of favored clinical practice for the management of chronic LBP. While the consensus statements were generally agreeable to survey respondents, some areas of ambiguity, including how to increase the feasibility of multidisciplinary strategies, when and how to use diagnostic imaging in LBP, and LBP classification, necessitate clarification in future studies and guidelines. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40122-021-00249-w. Springer Healthcare 2021-03-13 2021-06 /pmc/articles/PMC8119580/ /pubmed/33713307 http://dx.doi.org/10.1007/s40122-021-00249-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Varrassi, Giustino
Moretti, Biagio
Pace, Maria Caterina
Evangelista, Paolo
Iolascon, Giovanni
Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study
title Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study
title_full Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study
title_fullStr Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study
title_full_unstemmed Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study
title_short Common Clinical Practice for Low Back Pain Treatment: A Modified Delphi Study
title_sort common clinical practice for low back pain treatment: a modified delphi study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119580/
https://www.ncbi.nlm.nih.gov/pubmed/33713307
http://dx.doi.org/10.1007/s40122-021-00249-w
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