UK-Back Skills Training Trial (UK-BeST) A multi-centred randomised controlled trial of a primary-care based cognitive behavioural program (CBP) for low back pain (LBP)

ISRCTN ISRCTN54717854
DOI https://doi.org/10.1186/ISRCTN54717854
Secondary identifying numbers HTA 01/75/01
Submission date
17/09/2003
Registration date
23/09/2003
Last edited
30/09/2014
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Sarah Elizabeth Lamb
Scientific

Centre for Primary Health Care Studies
University of Warwick
Room 104
Avon Building
Westwood Campus
Coventry
CV4 7AL
United Kingdom

Phone +44 024 7657 4657
Email s.lamb@warwick.ac.uk

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeQuality of life
Scientific title
Study acronymUK-BeST
Study objectivesThe problem:
Low Back Pain (LBP) is a major public health problem. In any year, about 37% of the UK population report LBP, but not all people consult their general practitioner, or have long lasting symptoms. LBP has a substantial impact on the UK economy. Direct health care costs associated with LBP were estimated to be £1,628 million in 1998. Indirect costs, including lost production are even higher.

Cognitive Behavioural Therapy (CBT):
Over the recent years there has been considerable interest in CBT as a treatment for LBP, but few large controlled trials. CBT aims to empower people to better manage their back pain by learning skills of self-management. Important components of CBT are learning coping and pacing skills, non-pharmacological management of pain, countering negative beliefs about back pain and a graded activity programme in which people learn how to set themselves realistic goals. We have decided to use a group setting to deliver CBT as opposed to an individual treatment. We hope that people will be able to gain benefit from talking to one another, as has been shown in CBT programmes designed for other conditions.

The study:
Up to 700 people with a diagnosis of LBP, resulting in at least moderately troublesome symptoms and of at least 6 weeks duration will be identified through 93 practices of the Medical Research Council's General Practice Research Framework http://www.mrc-gprf.ac.uk/index.html. Potential participants will be invited to participate in a trial in which they will be allocated on a random basis to one of two treatment arms:
1. Advice from their general practice
2. Advice plus a group based cognitive behavioural program.

The costs of each strategy, and the clinical effects of the treatment will be monitored for a year.

More details can be found at: http://www.nets.nihr.ac.uk/projects/hta/017501
Protocol can be found at: http://www.nets.nihr.ac.uk/__data/assets/pdf_file/0016/50614/PRO-01-75-01.pdf

On 15/01/2008 the anticipated start and end date of this trial were changed from 01/10/2003 and 30/09/2006 to 06/10/2003 and 05/10/2008, respectively.
Ethics approval(s)West Midlands Multi-Centred Research Ethics Committee, Birmingham UK (MRC/03/7/04) provided the ethical review and approval.
Health condition(s) or problem(s) studiedLow Back Pain
InterventionGroup CBP, utilising an individualised assessment and promotion of self-management by
1. Patient education to counter negative beliefs about LBP
2. Use of cognitive re-structuring techniques to improve coping skills and self-efficacy (focusing on occupation and activity)
3. Goal setting, led by the paticipants
4. Pacing skills
5. Graded physical activity programme
6. Effective communication with health professionals.

Groups will allow for up to 6 hours of face-to-face contact with therapists, and will be conducted in a community or primary care facility.
Intervention typeOther
Primary outcome measure1. Pain and Disability measured using the Roland and Morris Questionnaire at months 0, 3, 6, 12
2. Pain measured using the Von Korff Scale at months 0, 3, 6, 12
Secondary outcome measuresSecondary outcome measures:
1. Occupational and other limitations measured by the numbers of days off work, reduced activity and bed rest at months 0, 3, 6, 12
2. Health-related quality of life including physical and mental health measured by Short Form 12 version 2 at months 0, 3, 6, 12
3. Back Pain Beliefs measured using Fear avoidance scale (1st five items only)* at months 0, 3, 6, 12
4. Self-efficacy measured using the Pain self-efficacy questionnaire at months 0, 3, 6, 12
5. Satisfaction with treatment measured using the single item rating of satisfaction with treatment at months 12

Economic analysis:
1. Resource Use measured using the resource use questionnaire at months 6 and 12
2. Health related quality of life; time trade off score measured using the EQ-5D (health utility) at months 0, 6, 12
Overall study start date06/10/2003
Completion date05/10/2008

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants700
Key inclusion criteria1. People with at least moderately troublesome low back pain of six weeks duration
2. Able to give informed consent
3. Aged over 18 years
Key exclusion criteriaExclusions will be based on pre-specified factors associated with serious pathologies.
Date of first enrolment06/10/2003
Date of final enrolment05/10/2008

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Centre for Primary Health Care Studies
Coventry
CV4 7AL
United Kingdom

Sponsor information

Department of Health (UK)
Government

Quarry House
Quarry Hill
Leeds
LS2 7UE
United Kingdom

Phone +44 (0)1132 545 843
Email Sheila.Greener@doh.gsi.gov.uk
Website http://www.dh.gov.uk/en/index.htm
ROR logo "ROR" https://ror.org/03sbpja79

Funders

Funder type

Government

NIHR Health Technology Assessment Programme - HTA (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 22/02/2007 Yes No
Results article results 13/03/2010 Yes No
Other publications description of development of intervention 01/06/2010 Yes No
Results article results 01/09/2011 Yes No
Results article results 01/02/2012 Yes No
Results article results 14/01/2014 Yes No