Efficacy and acceptability of pharmacological and non-pharmacological interventions for non-specific chronic low back pain: A protocol for a systematic review and network meta-analysis

Nicola Veronese, Sofia Dias, Damian Poulter, Claire Rossato, John P. A. Ioannidis, Trevor Thompson, Nicola Veronese, Elena Dragioti, Sharon Weldon, Joseph Firth, Trevor Thompson, Brendon Stubbs, Jae Il Shin, John P. A. Ioannidis, Lucy Marsh, Claire Rossato, Claire Rossato, Claire Rossato, John P. A. Ioannidis, Claire RossatoAndrea Cipriani, Marco Solmi, Andrea Cipriani, Christopher G. Maher, Jae Il Shin

Risultato della ricerca: Articlepeer review

3 Citazioni (Scopus)


Background: Despite the enormous financial and humanistic burden of chronic low back pain (CLBP), there is little consensus on what constitutes the best treatment options from a multitude of competing interventions. The objective of this network meta-analysis (NMA) is to determine the relative efficacy and acceptability of primary care treatments for non-specific CLBP, with the overarching aim of providing a comprehensive evidence base for informing treatment decisions. Methods: We will perform a systematic search to identify randomised controlled trials of interventions endorsed in primary care guidelines for the treatment of non-specific CLBP in adults. Information sources searched will include major bibliographic databases (MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO and LILACS) and clinical trial registries. Our primary outcomes will be patient-reported pain ratings and treatment acceptability (all-cause discontinuation), and secondary outcomes will be functional ability, quality of life and patient/physician ratings of overall improvement. A hierarchical Bayesian class-based NMA will be performed to determine the relative effects of different classes of pharmacological (NSAIDs, opioids, paracetamol, anti-depressants, muscle relaxants) and non-pharmacological (exercise, patient education, manual therapies, psychological therapy, multidisciplinary approaches, massage, acupuncture, mindfulness) interventions and individual treatments within a class (e.g. NSAIDs: Diclofenac, ibuprofen, naproxen). We will conduct risk of bias assessments and threshold analysis to assess the robustness of the findings to potential bias. We will compute the effect of different interventions relative to placebo/no treatment for both short- A nd long-term efficacy and acceptability. Discussion: While many factors are important in selecting an appropriate intervention for an individual patient, evidence for the analgesic effects and acceptability of a treatment are key factors in guiding this selection. Thus, this NMA will provide an important source of evidence to inform treatment decisions and future clinical guidelines. Systematic review registration: PROSPERO registry number: CRD42019138115 © 2020 The Author(s).
Lingua originaleEnglish
Numero di pagine11
RivistaSystematic Reviews
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

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