We describe the illness perceptions of patients with low back pain, how they change over 6 months, and their associations with
clinical outcome. Consecutive patients consulting eight general practices were eligible to take part in a prospective cohort study,
providing data within 3 weeks of consultation and 6 months later. Illness perceptions were measured using the Revised Illness Perception
Questionnaire (IPQ-R). Clinical outcome was defined using the Roland and Morris Disability Questionnaire (RMDQ) and
patients’ global rating of change. Associations between patients, perceptions and poor outcome were analysed using unadjusted and
adjusted risk ratios (RR) and 95% confidence intervals. 1591 completed questionnaires were received at baseline and 810 at 6
months. Patients had a mean age of 44 years and 59% were women. Mean (SD) RMDQ score at baseline was 8.6 (6.0) and 6.2
(6.1) at 6 months. 52% and 41% of patients had a poor clinical outcome at 6 months using RMDQ and global rating scores, respectively.
There were strong, statistically significant, associations (RRs of 1.4 and over) between IPQ-R baseline consequences, timeline
acute/chronic, personal control and treatment control scores and poor outcome. Patients who expected their back problem to last a
long time, who perceived serious consequences, and who held weak beliefs in the controllability of their back problem were more
likely to have poor clinical outcomes 6 months after they consulted their doctor. These results have implications for the management
of patients, and support the need to assess and address patients’ cognitions about their back problems.
2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved
We describe the illness perceptions of patients with low back pain, how they change over 6 months, and their associations withclinical outcome. Consecutive patients consulting eight general practices were eligible to take part in a prospective cohort study,providing data within 3 weeks of consultation and 6 months later. Illness perceptions were measured using the Revised Illness PerceptionQuestionnaire (IPQ-R). Clinical outcome was defined using the Roland and Morris Disability Questionnaire (RMDQ) andpatients’ global rating of change. Associations between patients, perceptions and poor outcome were analysed using unadjusted andadjusted risk ratios (RR) and 95% confidence intervals. 1591 completed questionnaires were received at baseline and 810 at 6months. Patients had a mean age of 44 years and 59% were women. Mean (SD) RMDQ score at baseline was 8.6 (6.0) and 6.2(6.1) at 6 months. 52% and 41% of patients had a poor clinical outcome at 6 months using RMDQ and global rating scores, respectively.There were strong, statistically significant, associations (RRs of 1.4 and over) between IPQ-R baseline consequences, timelineacute/chronic, personal control and treatment control scores and poor outcome. Patients who expected their back problem to last along time, who perceived serious consequences, and who held weak beliefs in the controllability of their back problem were morelikely to have poor clinical outcomes 6 months after they consulted their doctor. These results have implications for the managementof patients, and support the need to assess and address patients’ cognitions about their back problems.
2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved
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