TY - JOUR
T1 - Functional recovery in lumbar spine surgery
T2 - A controlled trial of health behavior change counseling to improve outcomes
AU - Skolasky, Richard L.
AU - Riley, Lee H.
AU - Maggard, Anica M.
AU - Bedi, Saaniya
AU - Wegener, Stephen T.
N1 - Funding Information:
The FRiLSS HBCC trial is supported by a grant from the Agency for Healthcare Research and Quality ( 1 R01 HS 017990 ).
PY - 2013/9
Y1 - 2013/9
N2 - In 2001, the Institute of Medicine issued a challenge to the American health care system to improve the quality of care by focusing on six major areas: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. The patient-centered model of care directly addresses important limits of surgical care of the lumbar spine, i.e., the lack of effective methods for increasing patient participation and engagement in post-operative follow-up. Recent evidence indicates that post-surgical outcomes are better among those with higher patient activation. We therefore developed an intervention based on the principles of motivational interviewing to increase patient activation: the Functional Recovery in Lumbar Spine Surgery Health Behavior Change Counseling (HBCC) intervention. The HBCC was designed to maximize post-operative engagement and participation in physical therapy and home exercise, to improve functional recovery, and to decrease pain in individuals undergoing elective lumbar spine surgery. From December 2009 through October 2012, 120 participants were recruited and divided into two groups: those receiving (intervention group, 60) and not receiving (control group, 60) the HBCC intervention. The current manuscript provides a detailed description of the theoretical framework and study design of the HBCC and describes the implementation of this health behavior intervention in a university-based spine service. The HBCC provides a model for conducting health behavioral research in a real-world setting.
AB - In 2001, the Institute of Medicine issued a challenge to the American health care system to improve the quality of care by focusing on six major areas: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. The patient-centered model of care directly addresses important limits of surgical care of the lumbar spine, i.e., the lack of effective methods for increasing patient participation and engagement in post-operative follow-up. Recent evidence indicates that post-surgical outcomes are better among those with higher patient activation. We therefore developed an intervention based on the principles of motivational interviewing to increase patient activation: the Functional Recovery in Lumbar Spine Surgery Health Behavior Change Counseling (HBCC) intervention. The HBCC was designed to maximize post-operative engagement and participation in physical therapy and home exercise, to improve functional recovery, and to decrease pain in individuals undergoing elective lumbar spine surgery. From December 2009 through October 2012, 120 participants were recruited and divided into two groups: those receiving (intervention group, 60) and not receiving (control group, 60) the HBCC intervention. The current manuscript provides a detailed description of the theoretical framework and study design of the HBCC and describes the implementation of this health behavior intervention in a university-based spine service. The HBCC provides a model for conducting health behavioral research in a real-world setting.
KW - Lumbar spine
KW - Motivational interviewing
KW - Patient activation
KW - Physical therapy
KW - Rehabilitation
KW - Spine surgery
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UR - http://www.scopus.com/inward/citedby.url?scp=84881005777&partnerID=8YFLogxK
U2 - 10.1016/j.cct.2013.06.018
DO - 10.1016/j.cct.2013.06.018
M3 - Article
C2 - 23816487
AN - SCOPUS:84881005777
SN - 1551-7144
VL - 36
SP - 207
EP - 217
JO - Contemporary Clinical Trials
JF - Contemporary Clinical Trials
IS - 1
ER -