Background: It is recommended practice that reassurance is provided to patients during the management of low back pain (LBP). However, the provision of reassurance within a consult varies, and it is uncertain what factors lead to higher or lower levels of reassurance delivery. Therefore, we aimed to determine whether there are patient characteristics that predict the level of reassurance provided, as reported by the patient after a LBP consultation.
Methods: 2048 adults presenting with a new episode of LBP to a chiropractor were included. Patient characteristics, including sociodemographic, clinical, and psychological characteristics were collected before the initial consultation, and the consultation-based reassurance questionnaire (CRQ) was completed by patients after the consultation. We investigated the association of patient characteristics on the patient-reported provision of reassurance during a consultation, as measured by the CRQ. We performed multiple imputations for missing patient characteristics and outcome variables. We performed univariate and multivariable analysis for each of the four sub-scales of the CRQ (data-gathering, relationship-building, cognitive reassurance, generic reassurance), using linear mixed models with a random intercept for clinicians to account for the dependency of observations.
Results: Patients with increased perceived risk of pain persistence reported receiving lower levels of reassurance across all subscales of the CRQ. Increased delivery of reassurance, across varied subscales, was reported by patients presenting with subacute pain (data-gathering, relationship building, cognitive reassurance), increased LBP intensity (relationship-building, generic reassurance), or older age (cognitive reassurance, generic reassurance).
Conclusion: These findings highlight that there are certain patient characteristics that can predict the level to which a person reports receiving reassurance during an initial consultation for LBP with a chiropractor. Patients with an increased perceived risk of pain persistence reported receiving less reassurance. Conversely, receiving more reassurance was reported by patients with subacute pain, increased LBP intensity, or older age. Future research should consider the impact of patient characteristics on the delivery of reassurance and the potential impact on LBP health outcomes.