Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain

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Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain
Key Take-Away: 

Home-based rehabilitation can be a fruitful technique to cure chronic low back pain (LBP), but this can work only if patients adhere to the recommendations regarding this rehabilitation program. This is possible by effective communication skills of physiotherapists enhanced by different interventions which are detailed in the presented randomized clinical trial by Lonsdale C and colleagues.

This study aimed to assess the effect of an intervention designed to enhance physiotherapists' communication skills on patients' adherence to recommendations regarding home-based rehabilitation for chronic low back pain. 

ABSTRACT: 
Background: 

This study aimed to assess the effect of an intervention designed to enhance physiotherapists' communication skills on patients' adherence to recommendations regarding home-based rehabilitation for

This study aimed to assess the effect of an intervention designed to enhance physiotherapists' communication skills on patients' adherence to recommendations regarding home-based rehabilitation for chronic low back pain. It is a cluster randomized controlled trial publicly funded by physiotherapy clinics.

Methods: 

A sample (N=308) of physiotherapists (n=53) and patients with chronic low back pain (n=255; 54% female patients; mean age, 45.3y) were included in the study.

Patients received publicly funded individual physiotherapy care. In the control arm, care was delivered by a physiotherapist who had completed a 1-hour workshop on evidence-based chronic LBP management. Patients in the experimental arm received care from physiotherapists who had also completed 8 hours of communication skills training. Main outcome measures were:

  1. Patient-reported adherence to their physiotherapists' recommendations regarding the home-based rehabilitation measured at 1, 4, 12, and 24 weeks after the initial treatment sessions.
  2. Pain and pain-related functions measured at baseline and at 4, 12, and 24 weeks.
Results: 

A linear mixed model analysis revealed that the experimental arm patients' ratings of adherence were higher than those of controls (overall mean difference,0 41; 95% confidence interval, CI 010–072; d=028; P=0.01).

Moderation analyses revealed that men, regardless of the intervention, showed improvements in pain-related function over time. Only women in the experimental arm showed functional improvements; female controls showed little change in function over time. The Communication Style and Exercise Compliance in Physiotherapy intervention did not influence patients' pain, regardless of their sex.

Conclusion: 

Communication skills training for physiotherapists had a short-term positive effect on patient adherence.

This training may provide a motivational basis for behavior change and could be a useful component in complex interventions to promote treatment adherence. The communication skills training may also improve some clinical outcomes for women, but not for men.

Source:

Archives of Physical Medicine and Rehabilitation

Link to the source:

http://www.archivespmr.org/article/S0003-9993(17)30183-1/fulltext?rss=yes

The original title of the article:

Communication skills training for practitioners to increase patient adherence to home-based rehabilitation for chronic low back pain: Results of a cluster randomized controlled trial

Authors:

Chris Lonsdale et al.

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