Design and development of a decision support package for low back pain

This study aimed to develop a decision support package for people with low back pain (LBP) referred for physiotherapy. The study used a program of exploratory work, consisting of literature reviews, a Delphi study, a nominal group with physiotherapists, focus groups with patients, and secondary analysis of existing interview data. The researches created an information booklet describing the evidence-based treatment modalities available in a physiotherapy department. This includes data on likely benefits and risks and how the intervention is administered. The booklet specifically deals with questions identified as important in the exploratory work. Space is provided for patients to note down the pros and cons of each treatment and what matters to them when choosing treatments. The patient is subsequently directed to a section that explores any gaps in knowledge, values, support, and choice before finally clarifying if a treatment decision is possible. At this stage they are prompted to note down any questions or concerns they have to be discussed at the first physiotherapy consultation. This overall package includes patient material in the form of a booklet posted prior to their consultation, plus the enhanced consultation with the specially trained physiotherapist. Patients then receive their chosen treatment. The authors also developed a training package for physiotherapists that explains the content of the booklet and supports them in using informed, shared decision making in their consultation.

This package has the potential to improve effectiveness of treatments and patient satisfaction for LBP by facilitating patient choice and therefore more effectively pairing patients with various treatments.