Table 6
Patient outcomes at 2-month follow-up
| Pre-intervention period | Post-intervention period | Difference | 95% CI | |||||
|---|---|---|---|---|---|---|---|---|
| N | Change | 95% CI | N | Change | 95% CI | |||
| Primary outcomes | ||||||||
| Function (RMDQ) | ||||||||
| Main analysis | ||||||||
| Control clinics | 297 | − 2.67 | (− 3.51, − 1.82) | 563 | − 3.08 | (− 3.82, − 2.33) | − 0.41 | (− 1.11, 0.29) |
| Intervention clinics | 249 | − 2.41 | (− 3.29, − 1.52) | 437 | − 3.15 | (− 3.93, − 2.38) | − 0.75 | (− 1.52, 0.03) |
| Difference | 0.26 | (− 0.96, 1.48) | − 0.08 | (− 1.15, 1.00) | − 0.34 | (− 1.38, 0.71) | ||
| P value | 0.530 | |||||||
| Subgroup, low risk | ||||||||
| Control clinics | 119 | − 5.19 | (− 5.99, − 4.39) | 237 | − 4.96 | (− 5.58, − 4.33) | 0.24 | (− 0.62, 1.10) |
| Intervention clinics | 112 | − 4.17 | (− 4.98, − 3.37) | 174 | − 5.12 | (− 5.81, − 4.43) | − 0.95 | (− 1.88, − 0.02) |
| Difference | 1.02 | (− 0.04, 2.08) | − 0.16 | (− 1.00, 0.67) | − 1.18 | (− 2.44, 0.08) | ||
| P value | 0.066 | |||||||
| Subgroup, moderate risk | ||||||||
| Control clinics | 110 | − 1.85 | (− 3.41, − 0.28) | 210 | − 2.97 | (− 4.37, − 1.58) | − 1.12 | (− 2.37, 0.12) |
| Intervention clinics | 89 | − 1.92 | (− 3.56, − 0.27) | 168 | − 2.87 | (− 4.31, − 1.43) | − 0.95 | (− 2.34, 0.44) |
| Difference | − 0.07 | (− 2.32, 2.19) | 0.10 | (− 1.88, 2.09) | 0.17 | (− 1.70, 2.04) | ||
| P value | 0.858 | |||||||
| Subgroup, high risk | ||||||||
| Control clinics | 68 | − 1.21 | (− 3.11, 0.69) | 116 | − 1.85 | (− 3.49, − 0.20) | − 0.64 | (− 2.47, 1.20) |
| Intervention clinics | 48 | − 1.56 | (− 3.60, 0.49) | 95 | − 1.62 | (− 3.31, 0.06) | − 0.07 | (− 2.21, 2.08) |
| Difference | − 0.35 | (− 2.75, 2.05) | 0.23 | (− 1.63, 2.08) | 0.57 | (− 2.27, 3.42) | ||
| P value | 0.693 | |||||||
| Pain intensity | ||||||||
| Main analysis | ||||||||
| Control clinics | 297 | − 1.48 | (− 1.78, − 1.18) | 558 | − 1.56 | (− 1.80, − 1.33) | − 0.08 | (− 0.41, 0.25) |
| Intervention clinics | 249 | − 1.31 | (− 1.63, − 0.99) | 430 | − 1.82 | (− 2.08, − 1.56) | − 0.51 | (− 0.88, − 0.14) |
| Difference | 0.17 | (− 0.27, 0.61) | − 0.26 | (− 0.61, 0.09) | − 0.43 | (− 0.93, 0.07) | ||
| P value | 0.09 | |||||||
| Subgroup, low risk | ||||||||
| Control clinics | 119 | − 2.22 | (− 2.64, − 1.81) | 234 | − 2.04 | (− 2.35, − 1.72) | 0.19 | (− 0.28, 0.65) |
| Intervention clinics | 112 | − 1.78 | (− 2.20, − 1.37) | 172 | − 2.24 | (− 2.59, − 1.89) | − 0.45 | (− 0.96, 0.05) |
| Difference | 0.44 | (− 0.11, 0.98) | − 0.20 | (− 0.62, 0.22) | − 0.64 | (− 1.32, 0.05) | ||
| P value | 0.069 | |||||||
| Subgroup, moderate risk | ||||||||
| Control clinics | 110 | − 1.12 | (− 1.75, − 0.48) | 209 | − 1.49 | (− 2.03, − 0.94) | − 0.37 | (− 0.94, 0.20) |
| Intervention clinics | 89 | − 1.1 | (− 1.77, − 0.43) | 164 | − 1.79 | (− 2.37, − 1.22) | − 0.7 | (− 1.33, − 0.06) |
| Difference | 0.02 | (− 0.90, 0.94) | − 0.31 | (− 1.09, 0.48) | − 0.33 | (− 1.18, 0.53) | ||
| P value | 0.452 | |||||||
| Subgroup, high risk | ||||||||
| Control clinics | 68 | − 0.66 | (− 1.47, 0.14) | 115 | − 0.83 | (− 1.52, − 0.14) | − 0.17 | (− 0.98, 0.64) |
| Intervention clinics | 48 | − 0.82 | (− 1.70, 0.05) | 94 | − 1.08 | (− 1.79, − 0.37) | − 0.25 | (− 1.20, 0.69) |
| Difference | − 0.16 | (− 1.19, 0.86) | − 0.25 | (− 1.02, 0.53) | − 0.08 | (− 1.34, 1.17) | ||
| P value | 0.895 | |||||||
| Secondary outcomes | ||||||||
| Continuous outcomes | ||||||||
| Depression (PHQ-8) | ||||||||
| Control clinics | 296 | − 1.42 | (− 1.91, − 0.93) | 557 | − 1.34 | (− 1.72, − 0.96) | 0.08 | (− 0.47, 0.63) |
| Intervention clinics | 249 | − 1.28 | (− 1.80, − 0.75) | 437 | − 1.42 | (− 1.84, − 1.00) | − 0.14 | (− 0.75, 0.46) |
| Difference | 0.14 | (− 0.58, 0.86) | − 0.08 | (− 0.65, 0.49) | − 0.22 | (− 1.04, 0.59) | ||
| P value | 0.592 | |||||||
| Anxiety (GAD-7) | ||||||||
| Control clinics | 297 | 0.76 | (0.38, 1.14) | 557 | 0.88 | (0.60, 1.16) | 0.12 | (− 0.36, 0.60) |
| Intervention clinics | 249 | 0.87 | (0.45, 1.29) | 436 | 0.71 | (0.39, 1.03) | − 0.16 | (− 0.68, 0.37) |
| Difference | 0.11 | (− 0.46, 0.68) | − 0.17 | (− 0.59, 0.26) | − 0.28 | (− 0.99, 0.44) | ||
| P value | 0.448 | |||||||
| Fear of movement (TSK) | ||||||||
| Control clinics | 297 | − 2.92 | (− 3.92, − 1.91) | 555 | − 2.8 | (− 3.59, − 2.02) | 0.11 | (− 1.02, 1.25) |
| Intervention clinics | 248 | − 2.51 | (− 3.59, − 1.42) | 434 | − 3.33 | (− 4.19, − 2.47) | − 0.82 | (− 2.09, 0.44) |
| Difference | 0.41 | (− 1.07, 1.89) | − 0.53 | (− 1.70, 0.64) | − 0.94 | (− 2.64, 0.76) | ||
| P value | 0.28 | |||||||
| Self-efficacy (PSEQ) | ||||||||
| Control clinics | 296 | 2.53 | (1.30, 3.76) | 561 | 2.87 | (1.89, 3.84) | 0.34 | (− 1.00, 1.68) |
| Intervention clinics | 249 | 2.55 | (1.23, 3.87) | 434 | 2.87 | (1.80, 3.94) | 0.32 | (− 1.17, 1.80) |
| Difference | 0.02 | (− 1.78, 1.83) | 0 | (− 1.45, 1.45) | − 0.02 | (− 2.03, 1.98) | ||
| P value | 0.982 | |||||||
| Effect on work productivity (0–10) | ||||||||
| Control clinics | 161 | − 1.06 | (− 1.37, − 0.74) | 303 | − 1.19 | (− 1.42, − 0.95) | − 0.13 | (− 0.50, 0.24) |
| Intervention clinics | 123 | − 1.23 | (− 1.58, − 0.87) | 226 | − 1.16 | (− 1.43, − 0.89) | 0.07 | (− 0.36, 0.49) |
| Difference | − 0.17 | (− 0.64, 0.31) | 0.03 | (− 0.33, 0.39) | 0.19 | (− 0.37, 0.76) | ||
| P value | 0.499 | |||||||
| Hours of work lost due to back pain | ||||||||
| Control clinics | 162 | − 2.15 | (− 2.93, − 1.37) | 299 | − 2.65 | (− 3.23, − 2.08) | − 0.5 | (− 1.47, 0.46) |
| Intervention clinics | 123 | − 3.4 | (− 4.29, − 2.50) | 227 | − 2.69 | (− 3.35, − 2.03) | 0.71 | (− 0.40, 1.83) |
| Difference | − 1.25 | (− 2.43, − 0.06) | − 0.03 | (− 0.91, 0.85) | 1.22 | (− 0.26, 2.69) | ||
| P value | 0.107 | |||||||
| Binary outcomes | ||||||||
| Completely recovered or much better (PGIC) | ||||||||
| Control clinics | 296 | 0.27 | (0.16, 0.38) | 554 | 0.3 | (0.21, 0.38) | 1.14 | (0.70, 1.84) |
| Intervention clinics | 249 | 0.21 | (0.12, 0.31) | 432 | 0.33 | (0.22, 0.44) | 1.85 | (1.07, 3.19) |
| OR | 0.72 | (0.40, 1.30) | 1.18 | (0.76, 1.81) | 1.63 | (0.79, 3.37) | ||
| P value | 0.189 | |||||||
| Very satisfied with care | ||||||||
| Control clinics | 285 | 0.47 | (0.31, 0.63) | 531 | 0.54 | (0.41, 0.68) | 1.35 | (0.88, 2.05) |
| Intervention clinics | 240 | 0.36 | (0.22, 0.50) | 425 | 0.48 | (0.34, 0.61) | 1.61 | (1.00, 2.58) |
| OR | 0.65 | (0.39, 1.07) | 0.77 | (0.53, 1.12) | 1.19 | (0.63, 2.24) | ||
| P value | 0.583 | |||||||
| Very satisfied with treatment | ||||||||
| Control clinics | 243 | 0.35 | (0.22, 0.48) | 434 | 0.3 | (0.21, 0.39) | 0.81 | (0.50, 1.29) |
| Intervention clinics | 205 | 0.28 | (0.16, 0.40) | 344 | 0.31 | (0.21, 0.41) | 1.13 | (0.67, 1.91) |
| OR | 0.73 | (0.42, 1.28) | 1.03 | (0.67, 1.58) | 1.4 | (0.69, 2.84) | ||
| P value | 0.344 | |||||||
| Very satisfied with information about cause | ||||||||
| Control clinics | 288 | 0.31 | (0.19, 0.43) | 530 | 0.38 | (0.27, 0.49) | 1.38 | (0.85, 2.23) |
| Intervention clinics | 247 | 0.29 | (0.16, 0.41) | 427 | 0.34 | (0.23, 0.45) | 1.3 | (0.76, 2.20) |
| OR | 0.894 | 0.5, 1.59 | 0.84 | 0.55, 1.29 | 0.94 | 0.46, 1.92 | ||
| P value | 0.864 | |||||||