Long-term results: a concise report from an extensive group with at least 5 years of follow-up

Long-term results of an intensive cognitive behavioural programme for patients with chronic low back pain:

A concise report from an extensive group with at least 5 years of follow-up

Groot, D., van Hooff, M. L., Kroeze, R. J., Monshouwer, M., O’Dowd, J., Horsting, P., & Spruit, M. (2019). Long-term results of an intensive cognitive behavioral pain management program for patients with chronic low back pain: a concise report of an extended cohort with a minimum of 5-year follow-up. European Spine Journal, 28(7), 1579-1585.

What is the research about?

Previous studies showed that the RealHealth programme was still effective after 1 and 2 years. But do these results persist in the long term? This study looked at patients who had followed the programme at least 5 years ago. The question was: are the positive effects still present, or has there been a relapse?

How was the research conducted?

Through structured interviews, 277 patients (85% response rate) were surveyed again at least 5 years after completing the RealHealth programme. The average follow-up was 6.5 years. The researchers looked at the same outcomes as before: daily functioning, quality of life, pain intensity, use of pain medication and healthcare use (doctor visits and pain medication use). They compared these results with the measurements taken before treatment and after 1 year.

The results

• The positive effects were fully maintained – and some even improved:

• Limitations (ODI score): improved from 40 to 27 after 1 year, and was still 28 after 6.5 years

• Pain intensity: improved from 60 to 39 after 1 year, and had improved even further to 33 after 6.5 years

• Quality of life: the improvement after 1 year remained stable after 6.5 years

• Use of healthcare: remained substantially lower than before treatment (fewer doctor visits and pain medication)

• Satisfaction: 74% of patients reported that after 6.5 years they still experienced improvement compared to before treatment

What is special about this?

This study shows that not only do the improvements persist after 6.5 years, but that the pain actually decreases even further during that period. Patients learn skills that they can apply throughout their lives.

What does this mean in practical terms?

If you follow the intensive programme and learn to apply the skills, the results are lasting – not for a few months or a year, but for many years. You will function better, experience less pain (and that pain will decrease even further over the years), and you will require less care on a structural basis. You invest two weeks in yourself, but the benefits last for years. This is not a temporary solution, but a fundamental change in how you deal with your back pain.

^{Abbreviations used
ODI (Oswestry Disability Index): Questionnaire that measures how much impact your back pain has on daily activities; NRS (Numerical Rating Scale): Scale from 0-10 to indicate your pain intensity (0 = no pain, 10 = worst pain imaginable).}