Individual Education for Patients With Chronic Low Back Pain: Likely a Clinically-Relevant Effect for Long-term Disability Compared to Non-educational Interventions. A Systematic Review With Meta-Analysis

OBJECTIVE: To assess the effectiveness of individual education for patients with chronic low back pain (CLBP), compared to no intervention, placebo, non-educational interventions, or other type of education. DESIGN: Intervention systematic review with meta-analysis of randomised controlled trials (RCTs). LITERATURE SEARCH: PubMed, CINAHL, PEDro, Embase, and Scopus (up to 14 January 2024); citation tracking in Web of Science, grey literature and reference lists of previous systematic reviews. STUDY SELECTION CRITERIA: We included RCTs that evaluated individual patient education interventions for adults with CLBP. DATA SYNTHESIS: Random effects meta-analysis for clinically homogeneous RCTs. We assessed risk of bias using the Cochrane Risk of bias 2.0, and applied the GRADE approach to assess the certainty of evidence. RESULTS: We included 17 RCTs (n = 1893). There was moderate certainty evidence that individual patient education had a clinically-relevant effect compared to non-educational interventions on long-term disability (SMD −0.23, 95%CI −1.13 to 0.66). There was moderate certainty evidence that individual patient education had no effect on short-term health-related quality of life compared to no intervention (MD −0.003, 95%CI −0.04 to 0.04), and no effect on medium-term disability (SMD 0.10, 95%CI −0.37 to 0.57) and long-term pain intensity (MD −2.20, 95%CI −14.43 to 10.03) compared to non-educational interventions. CONCLUSION: Individual patient education provided a clinically-relevant effect on long-term disability when compared to non-educational interventions. There were no other clinically-relevant effects of individual patient education for CLBP.