Gardner Tania, Refshauge Kathryn, McAuley James, Goodall Stephen, Hübscher Markus, Smith Lorraine
Faculty of Pharmacy, Sydney University, Sydney, Australia.
Faculty of Health Sciences, Sydney University, Sydney, Australia.
Patient Educ Couns. 2015 Aug;98(8):1035-8. doi: 10.1016/j.pec.2015.04.012. Epub 2015 Apr 27.
To determine the extent of alignment between clinical outcome measures and patient-derived goals for the management of chronic low back pain (cLBP).
A customised, patient-led goal setting intervention was implemented facilitated by a physiotherapist, in which participants identified problem areas and developed strategies to address them. Patient goals were compared to the most commonly used outcome measures in cLBP as well as research outcomes recommended by the IMMPACT consortium.
From 20 participants, a total of 27 unique goals were identified, the most common goal related to physical activity (49%). Comparison of participant goals to the most common measures used by physiotherapists found none of the goals could be aligned. Comparison of goals and domains with IMPACCT outcome domains found 76% of the goals were aligned with physical functioning and 16% with emotional functioning.
This study has identified goals important to patients in cLBP, these were varied, and most did not correspond with current clinical measures.
Clinical outcome measures may not be providing accurate information about the success of treatments that are meaningful to the patient. Clinicians should consider a collaborative approach with cLBP patients to determine treatment interventions that are driven by patient preference.
确定慢性下腰痛（cLBP）管理中临床结局指标与患者自身目标之间的一致程度。
在物理治疗师的协助下实施了一项由患者主导的定制目标设定干预措施，参与者在其中确定问题领域并制定应对策略。将患者目标与cLBP中最常用的结局指标以及IMMPACT联盟推荐的研究结局进行比较。
在20名参与者中，共确定了27个独特目标，最常见的目标与身体活动有关（49%）。将参与者目标与物理治疗师使用的最常见指标进行比较，发现没有一个目标能够匹配。将目标和领域与IMPACCT结局领域进行比较，发现76%的目标与身体功能相符，16%与情绪功能相符。
本研究确定了对cLBP患者重要的目标，这些目标各不相同，且大多数与当前临床指标不对应。
临床结局指标可能无法提供对患者有意义的治疗成功的准确信息。临床医生应考虑与cLBP患者采用协作方法，以确定由患者偏好驱动的治疗干预措施。
