Table 4

Process of Care and Clinical Outcomes at 6-Month Follow-up by Risk Group

Low RiskMedium RiskHigh Risk
OutcomePhase 1
(n = 136)
Phase 3
(n = 214)
P
Valuea
Phase 1
(n = 151)
Phase 3
(n = 232)
P
Valuea
Phase 1
(n = 81)
Phase 3
(n = 108)
P
Valuea
Process of care outcomes
Reconsulted physician, No. (%)19 (18)33 (22).4339 (31)74 (41).05630 (42)52 (58).03
Prescribed medications, No. (%)
 Nonsteroidal anti-inflammatory drugs46 (43)43 (28).0161 (48)71 (39).1529 (40)45 (51).19
 Antidepressants2 (2)8 (5).1619 (15)18 (10).2010 (14)16 (18).48
 Nonopioids11 (10)11 (7).3930 (23)30 (17).1425 (35)12 (13).001
 Opioids19 (18)47 (31).0244 (34)95 (53).00125 (35)59 (66)<.001
 Strong opioids12 (11)25 (16).2437 (29)49 (27).7524 (33)40 (45).13
 Weak opioids7 (7)22 (14).0467 (5)46 (26)<.0011 (1)19 (21)<.001
 Neuromodulators/antiepileptics0 (0)1 (1)1.0010 (8)4 (2).028 (11)15 (17).30
Issued sickness certification, No. (%)10 (9)11 (7).5421 (16)16 (9).04614 (20)13 (15).41
Blood test ordered, No. (%)33 (31)50 (33).7346 (36)65 (36).9831 (43)39 (44).92
MRI scan/radiograph ordered, No. (%)12 (11)10 (7).1920 (16)29 (16).9115 (21)16 (18).65
Clinical outcomes
Disability: change in RMDQ score0.9 (5.8)0.9 (4.5).873.4 (6.3)3.5 (6.0).212.3 (5.8)4.8 (6.8).004
Achieved MCID,b No. (%)67 (49)103 (48).6866 (44)113 (49).1722 (27)45 (42).06
Pain intensity: change in NRS rating1.0 (2.9)0.8 (3.0).832.3 (3.0)2.4 (3.1).521.9 (2.6)2.9 (3.3).02
Physical function: change in SF-12 PCS score−2.2 (15.2)−2.6 (16.5).98−5.7 (13.9)−4.0 (11.9).79−2.3 (13.1)−6.1 (14.8).051
Catastophizing: change in PCS-CAT score0.5 (7.8)0.5 (6.4).861.2 (7.3)1.1 (10.0).834.9 (8.6)6.0 (11.7).36
Fear avoidance: change in TSK score2.8 (9.2)3.1 (8.4).421.7 (7.6)3.3 (7.5).023.3 (7.1)5.3 (12.3).09
Anxiety: change in HADS subscale score0.7 (4.1)0.6 (4.2).820.8 (3.7)1.0 (4.0).092.1 (5.5)2.7 (4.3).22
Depression: change in HADS subscale score0.4 (4.1)0.6 (3.8).901.4 (3.3)1.4 (3.3).451.2 (4.3)2.7 (3.6).007
Mental health: change in SF-12 MCS score−1.1 (13.4)−0.2 (14.4).61−1.2 (13.8)−2.0 (12.8).23−4.8 (17.4)−6.4 (11.7).63
Pain self-efficacy: change in PSEQ score−4.9 (13.7)−3.1 (13.4).31−9.6 (16.8)−8.4 (15.2).72−8.4 (12.5)−12.6 (17.0).07
Global change since baseline: much improved, No. (%)67 (49)116 (54).4853 (35)88 (38).1119 (24)41 (38).09
Risk group: low risk, No. (%)117 (86)197 (92).5097 (64)169 (73).3035 (43)57 (53).02
Absenteeism since baselinec0.5 (2.3)0.9 (3.4).5011.3 (26.3)5.3 (18.7).00515.5 (35.5)9.4 (16.8).41
Presenteeismc1.5 (2.0)1.2 (1.5).322.3 (2.3)2.3 (2.8).873.7 (3.1)3.2 (2.8).62
Satisfied with care receivedd59 (75)81 (76).8777 (75)99 (70).3925 (54)35 (59).61
Satisfied with results of cared48 (62)81 (76).0363 (64)93 (68).5022 (47)35 (61).14
  • Notes: Values are mean (SD) unless otherwise noted. See Table 3 for abbreviations.

  • a P values were derived by χ2 test for the process outcomes, and by regression analyses for the clinical outcomes (adjusted for age, sex, family physician practice, baseline RMDQ score, duration of pain, and corresponding baseline value—as detailed in Table 3).

  • b Based on an MCID (≥30% reduction in RMDQ score from baseline) and rating of “completely recovered” or “much better” or “better” according to the global change question.

  • c Based on 290 of 547 respondents who reported being currently employed at the 6-month follow-up.

  • d Based on 536 respondents for the care received question and 524 for the results of care question at the 6-month follow-up.