Patient Education to PREVENT Chronic Low Back Pain


A commonwealth government funded (NHMRC) clinical trial that aimed to help people recover early from their acute low back pain episode and prevent developing chronic low back pain.

Researchers at NeuRA proposed that rather than waiting to treat patients who already had chronic low back pain, better outcomes could be achieved if they intervened early to reduce the risk of developing chronic low back pain after an acute episode.

The PREVENT trial included 202 participants with acute low back pain (fewer than 6‑week duration), lived in the greater Sydney region and showed a high risk of developing chronic low back pain. PREVENT was the first randomised, placebo-controlled trial for testing the effectiveness of early, specialised patient education for acute low back pain. Participants received recommended first-line care for acute low back pain from their usual practitioner. Participants received an additional two one-hour consultations of patient education (information on pain and biopsychosocial contributors plus self-management techniques, such as remaining active and pacing) or placebo patient education (active listening, but without information or advice).

The PREVENT trial found that by adding two hours of patient education to recommended first-line care for patients with acute low back pain did not reduce pain intensity or lead to a meaningful reduction in the development of disability. It was concluded that clinical guideline recommendations to provide complex and intensive support to high-risk patients with acute low back pain may have been premature.

PREVENT Media

Publications 
  • Cashin, A. G., Lee, H., Traeger, A. C., Moseley, G. L., Hübscher, M., Kamper, S. J., Skinner, I. W., & McAuley, J. H. (2022). Producing Clinically Meaningful Reductions in Disability: A Causal Mediation Analysis of a Patient Education Intervention. J Pain, 23(2), 236 – 247. doi:10.1016/j.jpain.2021.07.007
  • Cashin, A. G., Lee, H., Traeger, A. C., Hubscher, M., Skinner, I. W., & McAuley, J. H. (2021). Feeling reassured after a consultation does not reduce disability or healthcare use in people with acute low back pain: a mediation analysis of a randomised trial. J Physiother, 67(3), 197 – 200. doi:10.1016/j.jphys.2021.06.007
  • Traeger AC, Lee H, Hübscher M, Skinner IW, Moseley GL, Nicholas MK, Henschke N, Refshauge KM, Blyth FM, Main CJ, Hush JM, Lo S, McAuley JH. (2019). Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients with Acute Low Back Pain. A Randomized Clinical Trial. JAMA Neurology 2019 Feb 1;76(2):161 – 169. doi: 10.1001/jamaneurol.2018.3376. PMID: 30398542
  • Traeger, A. C., Skinner, I. W., Hubscher, M., Lee, H., Moseley, G. L., Nicholas, M. K., Henschke, N., Refshauge, K. M., Blyth, F. M., Main, C. J., Hush, J. M., Pearce, G., Lo, S., & McAuley, J. H. (2017). A randomized, placebo-controlled trial of patient education for acute low back pain (PREVENT Trial): statistical analysis plan. Braz J Phys Ther, 21(3), 219 – 223. doi:10.1016/j.bjpt.2017.04.005
  • Lee, H., Moseley, G. L., Hubscher, M., Kamper, S. J., Traeger, A. C., Skinner, I. W., & McAuley, J. H. (2015). Understanding how pain education causes changes in pain and disability: protocol for a causal mediation analysis of the PREVENT trial. J Physiother, 61(3), 156. doi:10.1016/j.jphys.2015.03.004