@article{f9d1f78ed4e849b7890e938942c4ae4e,
title = "Problem areas identified as important to older adults with lumbar spinal stenosis",
abstract = "Background Context: There is growing concern that patient-reported outcomes (PROs) commonly used in clinical research evaluating treatments such as epidural steroid injections (ESIs) for lumbar spinal stenosis may not adequately capture outcomes of greatest importance to older adults. Purpose: The purpose of the study was to determine what outcomes are most important to older adults with spinal stenosis, how well commonly used PROs reflect what is most important to these participants, and which outcomes older adults with spinal stenosis would want improved to consider having ESI. Study Design/Setting: This is an outcome prioritization study. Patient Sample: Community sample of 33 older adults with spinal stenosis were included. Outcome Measures: The outcome measures were Swiss Spinal Stenosis Questionnaire and Roland-Morris Disability Questionnaire. Methods: The methods involve individual sorting and ranking exercises followed by facilitated focus groups. Results: Highest rated problem areas were {"}experiencing pain/discomfort{"} (88% of participants), {"}problems with physical function{"} (85%), {"}difficulty exercising{"} (73%), {"}difficulty participating in hobbies and leisure activities{"} (55%), and {"}problems with weakness{"} (52%). Only 10 of the 24 Roland-Morris Disability Questionnaire items were rated by 50% or more of participants experiencing them as important enough to warrant ESI treatment. Conclusions: Older adults with spinal stenosis rated problems related to pain and physical function as the most important outcomes to them. However, difficulty exercising and difficulty participating in hobbies and leisure activities were also among the most highly rated and were two areas not typically assessed in treatment studies. Commonly used PROs in spinal stenosis treatment studies may be insufficient to comprehensively assess outcomes from the patient perspective.",
keywords = "Epidural steroid injections, Lumbar spinal stenosis, Outcomes, Patient centered, Prioritization, Treatment",
author = "Edwards, {Todd C.} and Lavallee, {Danielle C.} and Zoya Bauer and Comstock, {Bryan A.} and Jarvik, {Jeffrey G.} and Patrick, {Donald L.} and Makris, {Una E.} and Friedly, {Janna L.}",
note = "Funding Information: This study was funded by a contract with the Patient-Centered Outcomes Research Institute (contract #CE-12-11-4469). None of the authors have conflicts of interest to report related to this study. Funding Information: Author disclosures: TCE: Grant: PCORI Long-Term Outcomes of Lumbar Epidural Steroid Injections for Spinal Stenosis (LESSER) study (No. CE-12-11-4469 , H, Paid directly to institution). DCL: Grant: Patient-Centered Research Institute (H, Paid directly to institution). ZB: Grant: PCORI LESSER study (No. CE-12-11-4469 , H, Paid directly to institution); Grants: AHRQ Back pain Outcomes using Longitudinal Data-Extension of Research (BOLDER) study (No. R01 HS22972 , G, Paid directly to institution). BAC: Grant: PCORI LESSER study (No. CE-12-11-4469 , H, Paid directly to institution); Grants: AHRQ BOLDER study (No. R01 HS22972 , G, Paid directly to institution). JGJ: Grant: PCORI (No. CE-12-11-4469 , H), AHRQ ; Royalties: PhysioSonics (No. R01 HS22972 , A, a company that uses high-intensity focused ultrasound for diagnosis); Stock Ownership: PhysioSonics (∼2% ownership); Consulting: HealthHelp (C per year); Speaking and/or Teaching Arrangements: Duke University (A), Washington University, St Louis (A); Trips/Travel: GE-AUR Radiology Research Academic Fellowship and travel to Board of Review retreat (A for travel reimbursement); Scientific Advisory Board/other office: GE Healthcare and CER Advisory Board (C terminated consulting 10/2012); Grants: NIH (No. UH3 4UH3AR066795 , I, Paid directly to institution), AHRQ (I, Paid directly to institution). DLP: Grant: AHRQ (No. R01 HS22972 , G). UEM: Nothing to disclose. JLF: Grants: PCORI LESSER study (No. CE-12-11-4469 , H, Paid directly to institution); AHRQ BOLDER study (No. R01 HS22972 , G, Paid directly to institution). Publisher Copyright: {\textcopyright} 2015 Elsevier Inc. All rights reserved.",
year = "2015",
month = jul,
day = "1",
doi = "10.1016/j.spinee.2015.03.008",
language = "English (US)",
volume = "15",
pages = "1636--1644",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "7",
}