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Cited by 257Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationSpine and Intervertebral Disc Pathology

The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.

A randomized trial of a lay person-led self-management group intervention for back pain patients in primary care.

Von Korff, Michael, Moore, James E., Lorig, Kate, Cherkin, Daniel C., Saunders, Kathleen, González, Virginia M., Laurent, Diana, Rutter, Carolyn, Comite, Florence·1998·Spine
DOI 10.1097/00007632-199812010-00016
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Abstract

STUDY DESIGN: Randomized, controlled trial. OBJECTIVE: To evaluate a four-session self-management group intervention for patients with pain in primary care, led by trained lay persons with back pain. The intervention was designed to reduce patient worries, encourage self-care, and reduce activity limitations. BACKGROUND DATA: Randomized trials of educational interventions suggest that activating interventions may improve back pain outcomes. Expert opinion increasingly regards effective self-management of back pain as important in achieving good outcomes. In this study, an educational intervention designed to activate patients and support effective self-management was evaluated. METHODS: Six to 8 weeks after a primary care visit for back pain, patients were invited to participate in an educational program to improve back pain self-management. Those showing interest by returning a brief questionnaire became eligible for the study. Participants (n = 255) randomly were assigned to either a self-management group intervention or to a usual care control group. The effect of the intervention, relative to usual care, was assessed 3, 6, and 12 months after randomization, controlling for baseline values. The intervention consisted of a four-session group applying problem-solving techniques to back pain self-management, supplemented by educational materials (book and videos) supporting active management of back pain. The groups were led by lay persons trained to implement a fully structured group protocol. The control group received usual care, supplemented by a book on back pain care. RESULTS: Participants randomly assigned to the self-management groups reported significantly less worry about back pain and expressed more confidence in self-care. Roland Disability Questionnaire Scores were significantly lower among participants in the self-management groups relative to the usual care controls at 6 months (P = 0.007), and this difference was sustained at 12 months at borderline significance levels (P = 0.09). Among self-management group participants, 48% showed a 50% or greater reduction in Roland Disability Questionnaire Score at 6 months, compared with 33% among the usual care controls. CONCLUSIONS: Self-management groups led by trained lay persons following a structured protocol were more effective than usual care in reducing worries, producing positive attitudes toward self-care, and reducing activity limitations among patients with back pain in primary care.

Overview

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Registry

Crossref · 10.1097/00007632-199812010-00016

Cites

22 of 22 references verified0 citation errors · 0 not checkable

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Citations

Cites

Research works printed but not linked: 3

  1. Deyo, 1983, JAMA, 250, 1057, 10.1001/jama.1983.03340080035024 · DOI
  2. Lorig, 1993, Generations, 11-, 14
  3. Vlaeyen, 62, Pain, 363-, 72

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Metadata

Authors
Von Korff, M., Moore, J. E., Lorig, K., Cherkin, D. C., Saunders, K., González, V. M., Laurent, D., Rutter, C., & Comite, F.
Affiliations
  • Virginia Mason Medical Center (US)
  • Stanford University (US)
  • Group Health Cooperative (US)
  • Yale University (US)
Corresponding author
  • Cherkin, Daniel C.
  • Saunders, Kathleen
  • Rutter, Carolyn
ORCID
Venue
Spine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-12
Volume
23
Issue
23
Pages
2608-2615
ISSN
0362-2436 (ISSN-L)
DOI
10.1097/00007632-199812010-00016
OpenAlex
W2046947448
Cited by
257
References
22
Citations by year
2026: 3 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 9 · 2015: 13 · 2014: 3 · 2013: 15 · 2012: 11
FWCI
4.38
Type
journal article
Language
en
Open access
closed
Locations
  • Spine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Dental and Craniofacial Research (P01DE008773)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Keywords
back pain, self-management, group intervention, primary care, patient education, problem-solving strategies, disability, activity limitation, worry, self-care confidence, teaching materials
MeSH terms
Activities of Daily Living, Adult, Aged, Back Pain, Behavioral Symptoms, Disability Evaluation, Female, Health Maintenance Organizations, Humans, Male, Middle Aged, Pain Measurement, Patient Education as Topic, Primary Health Care, Surveys and Questionnaires, Self Care, Self-Help Groups, Washington, Treatment Outcome

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