@article {Gardner1424, author = {Tania Gardner and Kathryn Refshauge and James McAuley and Markus H{\"u}bscher and Stephen Goodall and Lorraine Smith}, title = {Combined education and patient-led goal setting intervention reduced chronic low back pain disability and intensity at 12 months: a randomised controlled trial}, volume = {53}, number = {22}, pages = {1424--1431}, year = {2019}, doi = {10.1136/bjsports-2018-100080}, publisher = {British Association of Sport and Excercise Medicine}, abstract = {Background One model of care that has not been tested for chronic low back pain (LBP) is patient-led goal setting. We aimed to compare the clinical effectiveness and healthcare use of a patient-led goal setting approach (intervention) with simple advice to exercise (control) over 12 months.Methods An assessor-blinded randomised controlled trial. Intervention was education combined with patient-led goal setting compared with a control group receiving a standardised exercise programme. The primary outcomes were back pain disability and pain intensity. Secondary outcomes were quality of life, kinesiophobia, self-efficacy, depression, anxiety and stress. Outcomes and healthcare use were assessed immediately post-treatment (2 months) and after 4 and 12 months. Analysis was by intention to treat.Results Seventy-five patients were randomly assigned to either the intervention (n=37) or the control (n=38) group. Using linear mixed model analyses, adjusted mean changes in primary outcomes of disability and pain intensity were greater in the intervention group than in the control group (disability post-treatment: p\<0.05). These differences were clinically meaningful. Mean differences in all secondary measures were greater in the intervention group than in the control group (p\<0.05). There was no difference in healthcare use between groups over 12 months.Conclusion A patient-led goal setting intervention was significantly more effective than advice to exercise for improving outcomes in disability, pain intensity, quality of life, self-efficacy and kinesiophobia in chronic LBP. These improvements were maintained at 12 months. Smaller effects were seen in measures of depression, anxiety and stress.Trial registration number ACTRN12614000830695.}, issn = {0306-3674}, URL = {https://bjsm.bmj.com/content/53/22/1424}, eprint = {https://bjsm.bmj.com/content/53/22/1424.full.pdf}, journal = {British Journal of Sports Medicine} }