Impact of Consultation Length on Satisfaction in Patients with Chronic Low Back Pain: A Nationwide Multicenter Study in Japan

Naohisa Miyakoshi; Daisuke Kudo; Yukihiro Matsuyama; Toshihiko Yamashita; Mamoru Kawakami; Kazuhisa Takahashi; Munehito Yoshida; Takashi Kaito; Shiro Imagama; Seiji Ohtori; Toshihiko Taguchi; Hirotaka Haro; Hiroshi Taneichi; Masashi Yamazaki; Gen Inoue; Kotaro Nishida; Hiroshi Yamada; Daijiro Kabata; Ayumi Shintani; Motoki Iwasaki; Manabu Ito; Hideki Murakami; Kazuo Yonenobu; Tomoyuki Takura; Joji Mochida

doi:10.22603/ssrr.2019-0111

Impact of Consultation Length on Satisfaction in Patients with Chronic Low Back Pain: A Nationwide Multicenter Study in Japan

Spine Surg Relat Res. 2020 Jan 29;4(3):208-215. doi: 10.22603/ssrr.2019-0111. eCollection 2020.

Authors

Naohisa Miyakoshi^{1

2}, Daisuke Kudo^{1

2}, Yukihiro Matsuyama^{3

2}, Toshihiko Yamashita^{4

2}, Mamoru Kawakami^{5

2}, Kazuhisa Takahashi^{6

2}, Munehito Yoshida^{7

2}, Takashi Kaito^{8

2}, Shiro Imagama^{9

2}, Seiji Ohtori^{10

2}, Toshihiko Taguchi^{10

2}, Hirotaka Haro^{11

2}, Hiroshi Taneichi^{12

2}, Masashi Yamazaki^{13

2}, Gen Inoue^{14

2}, Kotaro Nishida^{15

2}, Hiroshi Yamada^{16

2}, Daijiro Kabata^{17

2}, Ayumi Shintani^{17

2}, Motoki Iwasaki^{18

2}, Manabu Ito^{19

2}, Hideki Murakami^{20

2}, Kazuo Yonenobu^{21

2}, Tomoyuki Takura^{22

2}, Joji Mochida^{23

2}

Affiliations

¹ Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
² The Project Committee of the Japanese Society for Spine Surgery and Related Research (JSSR).
³ Division of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
⁴ Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
⁵ Spine Care Center, Wakayama Medical University Kihoku Hospital, Katsuragi-cho, Japan.
⁶ Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
⁷ Sumiya Orthopaedic Hospital, Wakayama, Japan.
⁸ Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
⁹ Department of Orthopaedics/Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
¹⁰ Department of Orthopaedic Surgery, Yamaguchi Rosai Hospital, Sanyoonoda, Japan.
¹¹ Department of Orthopaedic Surgery, University of Yamanashi, Chuo, Japan.
¹² Department of Orthopaedic Surgery, Dokkyo Medical University, Mibumachi, Japan.
¹³ Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
¹⁴ Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
¹⁵ Department of Orthopaedic Surgery, University of the Ryukyus, Faculty of Medicine, Nishihara, Japan.
¹⁶ Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan.
¹⁷ Department of Medical Statistics, Osaka City University Graduate School of Medicine and Faculty of Medicine, Osaka, Japan.
¹⁸ Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Japan.
¹⁹ Department of Orthopaedic Surgery, National Hospital Organization, Hokkaido Medical Center, Sapporo, Japan.
²⁰ Department of Orthopaedic Surgery, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.
²¹ Osaka Yukioka College of Health Science, Osaka, Japan.
²² Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
²³ Department of Orthopaedic Surgery, Japan Medical Alliance, Ebina General Hospital, Ebina, Japan.

Abstract

Introduction: Chronic low back pain (CLBP) is a major health burden worldwide and requires patient satisfaction with treatment. Consultation length can be an important factor in patient satisfaction, but few studies have investigated the impact of consultation length on satisfaction in patients with CLBP. This study tried to elucidate the impact of consultation length on clinical outcomes in patients with CLBP.

Methods: This study is part of an analysis using the database of the nationwide, multicenter cohort for CLBP performed by the Project Committee of the Japanese Society for Spine Surgery and Related Research. A total of 427 patients aged 20-85 years (median age, 73.0 years; female, 58.6%) with CLBP were prospectively followed-up monthly for 6 months. Multivariable nonlinear regression analyses were performed to assess the effect of consultation length on outcome measures including subjective satisfaction score, EuroQol 5-dimension, Japanese Orthopaedic Association (JOA) score, Roland-Morris Disability Questionnaire, JOA Back Pain Evaluation Questionnaire, visual analog scale (VAS) and Medical Outcome Survey short-form 8-item health survey that evaluated at the next phase. Furthermore, we assessed whether the effect of consultation length on patient satisfaction was modified by the baseline Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP) score for patient and physician versions.

Results: VAS for CLBP was the only score that correlated significantly with consultation length (P = 0.018). Satisfaction score showed a significant positive correlation with consultation length in patients with the highest baseline BS-POP scores (P < 0.2). Moreover, consultation lengths more than 7.6 min and 15.1 min offered increase of satisfaction if patients show the highest BS-POP scores on patient and physician versions, respectively.

Conclusions: These findings suggest that a sufficiently long consultation is an important factor for subjective satisfaction in the patients with CLBP, particularly in patients with psychological problems.

Keywords: chronic low back pain; consultation length; psychiatric problem; satisfaction.