Patient led goal setting in chronic low back pain—What goals are important to the patient and are they aligned to what we measure?

Tania Gardner, Kathryn Refshauge, James McAuley, Stephen Goodall, Markus Hübscher, Lorraine Smith

To determine the extent of alignment between clinical outcome measures and patient-derived goals for the management of chronic low back pain (cLBP). A customised, patient-led goal setting intervention was implemented facilitated by a physiotherapist, in which participants identified problem areas and developed strategies to address them. Patient goals were compared to the most commonly used outcome measures in cLBP as well as research outcomes recommended by the IMMPACT consortium. From 20 participants, a total of 27 unique goals were identified, the most common goal related to physical activity (49%). Comparison of participant goals to the most common measures used by physiotherapists found none of the goals could be aligned. Comparison of goals and domains with IMPACCT outcome domains found 76% of the goals were aligned with physical functioning and 16% with emotional functioning. This study has identified goals important to patients in cLBP, these were varied, and most did not correspond with current clinical measures. Clinical outcome measures may not be providing accurate information about the success of treatments that are meaningful to the patient. Clinicians should consider a collaborative approach with cLBP patients to determine treatment interventions that are driven by patient preference.