The Right Intervention for the Right Patient

NCT ID: NCT00459433

Last Updated: 2009-05-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-10-31

Study Completion Date

2009-05-31

Brief Summary

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Complicated and expensive interventions are used to treat unspecific low back pain and the intervention is not always targeted the patients specific problems.It is therefore not surprising that a large fraction of unspecific low back pain patients do not respond very well to the usual biopsychosocial intervention.

We would therefore like to identify the patients specific problems regarding the patients biomedical, psychological, and social needs.

Detailed Description

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Two quality assurance investigations are performed in the The Back Research Center Clinic, where one is published in The Spine. The systematics of Health Technology Assessment was used to throw light on important indicators in relation to Health Technology aspects, patient aspects, organisational aspects and economical aspects. At 12 months follow up in 1999, approximately one third of the patients stated that their low back pain was unchanged or worse. In 2004 in a new investigation this fraction was larger. Therefore it seems relevant to be able to identify the patients early in their course in the back ambulatory.

A Norwegian project has shown that when one divides the patients into 3 levels of severity, then the interdisciplinary biopsychosocial intervention had best effect in the intermediary and severe groups. Conversely the mono disciplinary intervention had best effect on the least severe patient group.

Therefore we would like to combine elements from the typical clinical investigation with a screening for psychosocial factors in order to sort patients according to their individual needs.

Even though the bio-psycho-social elements are a coherent continuum one can arbitrarily combine them in 4 groups of increasing complexity.

* mainly biological
* both biological and psychological
* both biological and social
* both biological, psychological and social It is probably not good enough to give more or less the same type of somatic treatment to all unspecific low back pain patients. It is important to take into account all three elements, the severity of the elements, and the combination of elements. To be able to do this it is important to use a combination of screening instruments that can isolate and quantify the manifestations of the three elements in the patients.

Conditions

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Low Back Pain

Keywords

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Low back pain Return to work Biopsychosocial Screening SMS Non specific low back pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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1

psychosocial intervention

Group Type EXPERIMENTAL

Biopsychosocial intervention

Intervention Type PROCEDURE

Psychosocial versus usual care

2

Usual care

Group Type ACTIVE_COMPARATOR

Biopsychosocial intervention

Intervention Type PROCEDURE

Psychosocial versus usual care

Interventions

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Biopsychosocial intervention

Psychosocial versus usual care

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Unspecific low back pain
* Level of low back pain must be at least equal to leg pain
* Patients must have been sick listed during the past 12 months
* Age \> 17 years and \< than 60

Exclusion Criteria

* Modic changes as seen on MRI
* Direct or progressive paresis or Cauda equina syndrome
* Known MB Bechterew or Sacroiliitis
* Suspicion of other serious malignancy
* Alcohol or medicine abuse
* A screening result of more than 30 in the Beck Depression Inventory
Minimum Eligible Age

18 Years

Maximum Eligible Age

59 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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European Commission

OTHER

Sponsor Role collaborator

The Back Research Center, Denmark

OTHER

Sponsor Role lead

Responsible Party

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The Back Research Center, Denmark

Principal Investigators

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Bendt Johansen, MHS

Role: PRINCIPAL_INVESTIGATOR

Affiliated with University of Southern Denmark

Locations

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The Back Research Center

Ringe, , Denmark

Site Status

Countries

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Denmark

References

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Johansen B, Mainz J, Sabroe S, Manniche C, Leboeuf-Yde C. Quality improvement in an outpatient department for subacute low back pain patients: prospective surveillance by outcome and performance measures in a health technology assessment perspective. Spine (Phila Pa 1976). 2004 Apr 15;29(8):925-31. doi: 10.1097/00007632-200404150-00021.

Reference Type BACKGROUND
PMID: 15082998 (View on PubMed)

Haldorsen EM, Grasdal AL, Skouen JS, Risa AE, Kronholm K, Ursin H. Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain. Pain. 2002 Jan;95(1-2):49-63. doi: 10.1016/s0304-3959(01)00374-8.

Reference Type BACKGROUND
PMID: 11790467 (View on PubMed)

Other Identifiers

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258

Identifier Type: -

Identifier Source: org_study_id