Are patient expectations associated with treatment outcomes in individuals with chronic low back pain? A systematic review of randomised controlled trials
Open accessAbstract
AIM: The importance of patient expectations (PEs) on treatment outcomes is poorly understood in clinical practice. The aim of this review is to investigate the evidence behind association between pre-treatment PEs and treatment outcomes such as pain intensity (PI), level of function (LF) and health-related quality of life (HRQoL) among individuals with chronic low back pain (CLBP). METHODS: A systematic search was conducted for randomised controlled trials published between 1946 and May 2019 across major databases using the key MeSH terminologies. The association between PEs and PI, LF and HRQoL were extracted and categorised into positive, negative or no association for analysing the data. A descriptive synthesis was conducted and the association between PEs and PI, LF and HRQoL were reported. RESULTS: Among the total of seven trials, two trials demonstrated a positive association between PEs and PI in short (≤6 weeks) and long term (>6 months), while another two trials demonstrated no association at medium term (>6 weeks-≤6 months). About four trials demonstrated a positive significant association between PEs and LF, 2 at medium and 2 at long terms. The only available trial demonstrated no association between PEs and HRQoL at medium term. CONCLUSION: PEs is associated with PI at short and long terms. Also, evidence suggests association between PEs and LF at medium and long terms. Currently, there is no evidence of association between PEs and HRQoL. Further studies with valid tools to measure PE are warranted among individuals with CLBP.
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Patient expectations about treatment effectiveness can significantly impact health outcomes.
“Numerous studies show that patient expectations about treatment effectiveness can significantly impact health outcomes (Mohamed Mohamed et al., 2020; Laferton et al., 2017; Bingel, 2020; Colloca et al., 2004).”
From Revisiting the SSRI vs. placebo debate in the treatment of social anxiety disorder: the role of expectancy effects, neural responsivity, and monoamine transporters (2025) · cites this paper as Mohamed Mohamed et al., 2020
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“1 | Study criteria The studies were included if (1) they are published in the English language; (2) they are randomised control trials (RCTs) or a secondary analysis of RCTs; (3) report data from participants aged between 18 and 70 years (as this range of age group has been generally reported with low back pain in the…”
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Expectations, perceptions, and physiotherapy predict prolonged sick leave in subacute low back pain
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Jiang, L., Wang, L., Zhan, D.-S., Jiang, W.-R., Fodjo, E. K., Hafez, M. E., Zhang, Y.-M., Zhao, H., Qian, R.-C., & Li, D.-W. (2021) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2020.112918 · Cited by 41 · see citing works
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- Authors
- Mohamed Mohamed, W. J., Joseph, L., Canby, G., Paungmali, A., Sitilertpisan, P., & Pirunsan, U.
- Affiliations
- School of Health Science University of Brighton East Sussex UK
- University of Brighton (GB)
- Chiang Mai University (TH)
- Corresponding author
- Joseph, Leonard
- Venue
- International Journal of Clinical Practice
- Publisher
- Wiley
- Published
- 2020-09-07
- Volume
- 74
- Issue
- 11
- Pages
- e13680-e13680
- ISSN
- 1368-5031 (ISSN-L)
- 1742-1241
- OpenAlex
- W3082311850
- Cited by
- 48
- References
- 8
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 17 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 1
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Clinical Practice (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Brighton Repository (University of Brighton) (publishedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- patient expectations, chronic low back pain, treatment outcomes, pain intensity, functional level, health-related quality of life, placebo effect
- MeSH terms
- Humans, Motivation, Quality of Life, Randomized Controlled Trials as Topic, Treatment Outcome, Low Back Pain, Chronic Pain
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