- New international research has found patients with back pain want choices and facts, not instructions.
- Low back pain is the second most common reason for seeking care from a primary care physician (GP).
- The research, which included collaborators from Neuroscience Research Australia (NeuRA) and UNSW Sydney, found a patient fact sheet outlining management options was more effective than an advice sheet.
Few people like being told what to do and this includes people with low back pain. New research has found patients want to be empowered with the knowledge to make informed choices, not advice.
The study published today in JAMA Network Open has found that simple, one-page fact sheets listing evidence-based treatment options better prepare patients to make decisions about managing their pain than traditional advice-based materials.
The randomised clinical trial was led by an international team of researchers, including senior author, Director of the Centre for Pain IMPACT at Neuroscience Research Australia (NeuRA) and Professor in the UNSW Sydney Faculty of Medicine and Health, Professor James McAuley. The study tested two types of patient resources commonly used in GP clinics: one that listed treatment options (such as staying active, using heat, or trying physical therapies) and another that advised patients what they should do.
"The findings were clear: patients who received the more neutral, information-rich sheet that outlined options, felt better prepared to participate in shared decision-making with their doctor," Prof McAuley said.
"This flips the script on how we talk to patients. People don't want to be told what to do. They want honest, balanced information so they can decide what works best for them. This might seem obvious, clinical guidelines suggest the opposite approach."
Study supported by patients
Importantly, the research team worked closely with consumer partners throughout the study.
"As someone living with long-term back pain, I don't want a handout that lectures me," said Steve Marsh, a consumer advocate who collaborated on the study. "What I need is clear, trustworthy information that helps me have a real conversation with my doctor, not a script for how I should feel or what I should choose."
Study shows benefits of shared decision-making
"The effect was strongest among people with chronic low back pain, who often face complex, long-term treatment decisions," Prof McAuley said.
"Although the benefits of shared decision-making are well established, including improved satisfaction, reduced unnecessary tests, and greater adherence, this is the first study to show that how we present information affects patient readiness to engage. Brief, balanced materials may work better than traditional advice-heavy handouts, especially for people with ongoing pain."
Lead author, Dr Christian Longtin from the University of Sherbrooke in Canada, agreed.
"In primary care, time is tight," Dr Longtin said.
"A well-designed one-page sheet could be a powerful tool, if we get the tone right."
The study recruited more than 1,000 adults in Australia, most of whom had just seen a doctor for back pain. Participants were randomly given one of the two fact sheets and immediately asked how prepared they felt to make care decisions.
"This research adds to growing evidence supporting patient-centred care and could influence how health services design educational materials for a wide range of conditions," Prof McAuley said.
"Interestingly, neither type of fact sheet changed patients' intentions to seek high- or low-value care such as imaging or opioids. This highlights the need for more targeted strategies if the goal is to shift behaviour."
The full study is available on JAMA Network Open (2025): https://doi.org/10.1001/jamanetwork
