Development, validation and evaluation of a novel self-instructional module in patients with chronic non-specific low back pain

Babita Ghai; Kapil Gudala; Mir M Asrar; Neha Chanana; Raju Kanukula; Dipika Bansal

doi:10.4103/ija.IJA_779_19

Development, validation and evaluation of a novel self-instructional module in patients with chronic non-specific low back pain

Indian J Anaesth. 2020 Apr;64(4):299-305. doi: 10.4103/ija.IJA_779_19. Epub 2020 Mar 28.

Authors

Babita Ghai¹, Kapil Gudala², Mir M Asrar², Neha Chanana³, Raju Kanukula², Dipika Bansal²

Affiliations

¹ Department of Anesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
² Clinical Research Unit, Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Mohali, Punjab, India.
³ Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Abstract

Background: Low back pain (LBP) is ranked highest in terms of disability-adjusted life-years lived. Patient education and self-management have shown to play a crucial role in the overall pain management. However, the literature on the same with respect to Indian context is still lacking. The study was aimed to develop, validate and assess the acceptability and effectiveness of self-instructional educational module among Indian chronic LBP (CLBP) patients.

Methods: A prospective single-arm open-label study was conducted in a pain clinic of a tertiary care public hospital in North India with 'Backcare booklet-self-instructional module (SIM)' as an intervention in patients with CLBP. SIM was developed with the intent to provide up-to-date evidence-based information in an easy understanding way to patients with CLBP. 132 patients were administered SIM with a single session of verbal explanation. Pain intensity (numeric rating scale [NRS]), disability, fear-avoidance belief Questionnaire (FABQ), quality of life (EQ5D) and knowledge level were assessed at baseline and after 3 months of intervention. Student's paired t-test and Chi-square test were used. Data were analysed using SPSS version 15.0.

Results: 120 patients successfully completed the 3 months' follow-up. Significant reductions were observed in pain intensity (76[12] vs 55 [15, P < 0.01); disability (51[14] vs 43 [10], P < 0.01); FABQ (46[12] vs 41 [10], P < 0.01); EQ5D (0.35 [0.27] vs 0.18 [0.26], P < 0.01).

Conclusion: Backcare booklet as an intervention, along with usual pharmacological care is a cost-effective educational medium to promote self-management of CLBP in the clinical outpatient settings.

Keywords: EQ5D; Low back pain; fear-avoidance belief questionnaire (FABQ); functional disability; knowledge level; pain intensity; self-instruction module.