Releases Saturday 23 June 2001
No 7301 Volume 322
Please remember to credit the BMJ as source when publicising
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(1) MASS MEDIA CAMPAIGNS CAN ALTER
BELIEFS ABOUT BACK PAIN
(2) INTENSIVE
THERAPY IMPROVES LOW
BACK PAIN,
BUT IS IT WORTH THE COST?
(3) WOMEN
WITH CYSTIC FIBROSIS "TOO
EMBARRASSED"
TO SEEK HELP FOR
INCONTINENCE
(1) MASS MEDIA
CAMPAIGNS CAN ALTER
BELIEFS ABOUT BACK PAIN
(Population based intervention to
change back pain
beliefs and disability: three part
evaluation BMJ)
http://bmj.com/cgi/content/full/322/7301/1516
New research in this week's BMJ finds that
mass
media campaigns can alter people's beliefs
about
back pain, improve knowledge and attitudes
among
doctors and reduce compensation claims
for back
problems.
Researchers in Victoria, Australia measured
the
effectiveness of a state-wide public health
campaign
designed to alter beliefs about back pain.
The
campaign comprised television commercials,
radio
and print advertisements, outdoor billboards,
posters, seminars, workplace visits, and
publicity
articles. The Back Book, an educational
booklet
for patients, was also made widely available
and all
doctors in Victoria received guidelines
for the
management of employees with low back
pain who
were eligible for compensation.
The team conducted before and after telephone
surveys among 4,730 members of the general
population and postal surveys of 2,556
general
practitioners, with an adjacent state
(New South
Wales) as control.
In Victoria, beliefs about back pain became
more
positive between successive surveys. Knowledge
and attitudes towards treating back pain
also
improved among doctors. There was a clear
decline in number of claims for back pain,
rates of
days compensated, and medical payments
for
claims for back pain over the duration
of the
campaign.
These findings clearly demonstrate the
value of
promoting positive messages about back
pain to
the general population, say the authors.
Further
research should measure whether the effect
of the
campaign is sustained over time. These
findings
should also encourage others to adapt
the
campaign for use and evaluation in other
settings,
they conclude.
Contact:
Rachelle Buchbinder, Associate Professor
and
Director, Department of Clinical Epidemiology,
Cabrini Hospital, Victoria, Australia
Email: rachelle.buchbinder{at}med.monash.edu.au
(2) INTENSIVE
THERAPY IMPROVES LOW
BACK PAIN, BUT IS IT WORTH THE COST?
(Multidisciplinary rehabilitation
for chronic low back
pain: systematic review)
http://bmj.com/cgi/content/full/322/7301/1511
Intensive rehabilitation programmes
reduce pain and improve function in patients
with
chronic low back pain, concludes a study
in this
week's BMJ, but it remains unclear whether
the
improvements are worth the cost of these
intensive
treatments.
Disabling low back pain is thought to be
a result of
interrelating physical, psychological,
and social or
occupational factors requiring multidisciplinary
treatment. The research team reviewed
10 trials,
involving nearly 2,000 adults with low
back pain, to
assess the impact of such multidisciplinary
treatment
approaches.
The reviewed studies provided evidence
that
intensive multidisciplinary treatment
produces
greater improvements in pain and function
for
patients with disabling chronic low back
pain than
less intensive multidisciplinary programmes,
non-multidisciplinary rehabilitation or
usual care.
However, these intensive programmes might
have a
large impact on healthcare resources,
say the
authors, and it is not clear whether the
benefits
outweigh the costs. The final judgement
will depend
on societal resources, available alternatives,
and the
value attached to reducing human suffering
from
back pain, they conclude.
Contact:
Jaime Guzman, Research Associate, University
of
Manitoba Faculty of Medicine, Winnipeg,
Canada
Email: guzmanjo{at}cc.umanitoba.ca
(3) WOMEN WITH
CYSTIC FIBROSIS "TOO
EMBARRASSED" TO SEEK HELP FOR
INCONTINENCE
(Questionnaire survey of urinary
incontinence in
women with cystic fibrosis)
http://bmj.com/cgi/content/full/322/7301/1521
A study in this week's BMJ finds that over
two-thirds of women with the chest disease
cystic
fibrosis suffer urinary incontinence,
yet are reluctant
to seek help. Given that incontinence
can affect a
patient's ability to perform essential
daily treatment
procedures, addressing this problem should
become part of the routine management
of cystic
fibrosis, report the authors.
Researchers at the Adult Cystic Fibrosis
Unit in
Manchester invited women attending the
clinic to
complete an anonymous questionnaire. The
questions related to the severity, causes,
and
physical or social impact of leakage when
the chest
was "good" or "bad".
Of 75 questionnaires completed, 68% of
women
reported leakage of urine in the previous
12
months. They reported coughing, sneezing,
laughing
and airway clearance as the major causes
of
leakage, which was worse when the chest
was
"bad." Eight women reported leakage affecting
their
ability to perform airway clearance. This
is
particularly worrying, say the authors,
as cystic
fibrosis requires lifelong daily treatment
by airway
clearance to assess and manage the impace
of the
disease on the lungs.
More than a quarter of women were severely
distressed by their incontinence, and
20% had
sought help previously. Reasons given
for not
seeking help included "not as serious
as my chest
disease" and "too embarrassed." A wish
for
treatment was expressed by 35% of women.
The low number of women who wanted help
for
their reported leakage is reason for concern,
say
the authors. A practical and sensitive
approach
needs to be developed to evaluate this
little
recognised condition in women who already
have
the burden of cystic fibrosis, they conclude.
Contact:
Alison Orr, Senior Physiotherapist, Adult
Cystic
Fibrosis Unit, North West Lung Centre,
South
Manchester University Hospitals Trust,
Manchester, UK
Email: alison.orr{at}smuht.nwest.nhs.uk
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