Physiotherapy July 2000/vol 86/no 7 375 Abstracts Evaluation of a Multidisciplinary Pain Management Programme in Patients with Chronic Low Back Pain M P Armstrong, S McDonough Rehabilitation Sciences Research Group, University of Ulster at Jordanstown, N Ireland I Gillespie, A Kenny, L Carson, L Magee, G D Baxter Belfast City Hospital Trust, N Ireland Chronic low back pain (CLBP) is a major public concern. A common recommendation is to refer these patients to a multidisciplinary pain management programme (PMP). The aim of this study was to evaluate the effectiveness of a multidisciplinary PMP in patients presenting to the Belfast City Hospital Trust with CLBP. Subjects Ninety consecutive patients (60 women and 30 men) who were referred to the PMP at the Belfast City Hospital Trust were selected. Method The patients completed a three-week outpatient multidisciplinary programme. The healthcare team consisted of a consultant anaesthetist, clinical psychologist, physiotherapist and occupational therapist. The sessions included formal education, a cognitive behavioural component, a practical physical session and relaxation. Outcome measures chosen were the Oswestry Low Back Disability Questionnaire (ODQ) (Fairbank et al, 1980); Roland Morris Disability Questionnaire (RMQ) (Roland and Morris, 1983); visual analogue scale (VAS) (Huskisson, 1983); McGill Pain Questionnaire (MPQ) (Melzack,1975); and the coping strategies questionnaire (CSQ) (Rosentiel and Keefe, 1983). All patients were assessed before and immediately after the programme, and followed up three months later. Results The mean age of the women was 42.5 years, of the men 43.4 years. The mean duration of pain in the women was 7.3 years, in the men 6.8 years. At discharge from the programme, there was a statistically significant improvement in all measures of functional disability (RMQ p < 0.001, ODQ p < 0.001) and in all measures of pain (MPQ-PRI p < 0.001, MPQ-PPI p < 0.001, VAS p < 0.001). One-year Predictive Utility of Biopsychosocial Screening Questionnaire for Low Back Pain-Related Outcomes D A Hurley, S M McDonough, G D Baxter. T E Dusoir University of Ulster at Jordanstown, N Ireland A P Moore Clinical Research Unit for Healthcare Professions, University of Brighton, Eastbourne There is growing evidence that biopsychosocial factors can influence low back pain (LBP) outcomes. Consequently, there is a need for practical biopsychosocial screening measures that can be incorporated into clinical settings. A one-year prospective study was conducted, in which subjects who first completed a biopsychosocial screening instrument, the Acute Low Back Pain Screening Questionnaire (ALBPSQ) (Linton and Hallden, 1998) and then received physiotherapy in the Northern Ireland National Health Service were followed up. This study aimed to evaluate associations between LBP-related outcomes at follow-up and the ALBPSQ cut-off score of 112 (Hurley et al, 2000). Ethical approval was obtained from the Research Ethical Committee of the University of Ulster. One hundred and eighteen consenting subjects with LBP who had received physiotherapy one year previously were posted follow-up questionnaires and self-addressed envelopes. There was a good response rate (n = 90, 76%). The ALBPSQ cut-off score ≤ 112 > significantly discriminated between subjects for all of the outcomes except recurrence of LBP, ie 'additional healthcare consumption', 'work loss', 'medication usage for LBP', 'leisure time exercise participation', 'general health status', and 'effect on daily activities' (P < 0.05, Hochberg's modified Bonferroni procedure for multiple tests of significance). Additionally, Kendall's rank-order correlation coefficient showed that subjects who scored ALBPSQ ≤ 112 before starting physiotherapy had significantly less pain (McGill Pain Questionnaire, τ = 0.2552, P = 0.006) and functional disability (Roland Morris Disability Questionnaire: τ = 0.381, P = 0.000) values at one-year follow-up, compared to subjects who scored ALBPSQ > 112. Scores on the ALBPSQ completed one year previously were significantly associated with a range of LBP-related variables and correctly predicted the majority of subjects who displayed poor outcomes at follow-up. Further investigations in other health care settings contribute to this growing evidence base and determine the potential clinical utility of this biopsychosocial screening instrument. Acknowledgement The authors acknowledge grant support from the Society of Orthopaedic Medicine and the Manipulation Association of Chartered Physiotherapists. Thanks are extended to the many trust physiotherapists who participated in this study. References Linton, S J and Hallden, K (1998). ‘Can we screen for problematic back pain? A screening questionnaire for predicting outcome in acute and subacute back pain’, Clinical Journal of Pain, 14, 209-215. Hurley, D A, Dusoir, T E, McDonough, S M, Moore, A P, Linton, S J and Baxter, G D (2000). ‘Low back pain biopsychosocial screening questionnaire: What are the implications for physiotherapy practice?’ Journal of Bone and Joint Surgery, in press.