134. STANDARDISED WRITTEN INFORMATION ALLOWS A REDUCTION IN THE RESIDUAL FUNCTIONAL INCAPACITY AFTER LUMBAR DISCECTOMY: A CONTROLLED RANDOMISED TRIAL

Abstract

Purpose of the study: Evaluate the impact of an information brochure on residual functional incapacity after lumbar discectomy for common lumbosciatic pain.

Material and methods: A biopsychosocial information brochure on the management of chronic pain was developed on the basis of evidence-based medicine. A prospective randomised controlled trial was conducted to assess its impact. One hundred twenty-nine patients were included. The intervention group (GI) was given the biopsychosocial brochure entitled “You have had a back operation” (Vous venez d’être opéré du dos) while the control group was given a biomedical brochure. The information content was the only difference between the two groups; the patients were not informed of their randomisation group. The main outcome was functional incapacity at two months (Quebec scale). The duration of return to usual daily and occupational activities was noted at two months. Secondary outcomes were fears and beliefs measured by the FABQ and the BBQ before and after information delivery and at two months. Radicular and low back pain were evaluated using a numerical scale. Satisfaction with information received was determined. All demographic and clinical data were collected with self-administered questionnaires.

Results: Functional incapacity at two months declined more in GI: 32.4±22.8 versus 36.1±18.7 in the control group (p=0.36). The biopsychosocial brochure favoured resumption of usual physical activity: since 2.38±2.47 weeks in GI versus 1.00±1.28 weeks in the control group (p=0.0006) and of occupational activity: 2.35±1.17 weeks in GI versus ±Discussion: in the control group and for significantly more patients in GI (p=0.02). Fears and beliefs measured by the FABQPhys declined significantly in GI: from 15.9±6.3 to 8.0±7.14 versus from 14.1±5.6 to 11.23±6.34 in the control group; this score remained lower in GI at two months: 8.64±7.6 versus 10.63±7.2 (p=0.18). The patients in GI were significantly more satisfied with the information received.

Discussion: Reading the biopsychosocial brochure had a significant impact on functional incapacity in terms of time to resumption of physical and occupational activities and enabled a reduction in fears and beliefs.

Conclusion: This information brochure is an interesting tool for healthcare professionals and contributes to therapeutic education of patients.