Reassurance for patients with non-specific conditions - a user's guide.
Adrian C Traeger, Edel T O'Hagan, Aidan Cashin and 1 others
PMID 28442069WHAT IT FOUND
Reassurance is harder than it looks.
Negative test results may not calm patients, and brief education can reduce some fears but not worry, catastrophising or depression. Tell patients what you know, and avoid platitudes that may add concern.
Key findings
01Negative diagnostic tests did not reliably reduce fear or concern, and radiological reports in low back pain might worsen disability outcomes.
02Patient education can reduce fears about back pain and subsequent health services use in a cited systematic review of 14 trials with 4872 participants, including interventions as short as 5 minutes with effects up to 12 months.
03Using the PICKUP prognostic model in Australian primary care could lead a 40% reduction in unnecessary interventions for patients with a good prognosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a narrative guide, not a systematic review, so it does not describe how sources were selected. It reports no new patients or outcomes, so its claims depend on cited studies. Most examples are low back pain, so it may not apply to all non-specific conditions. The review notes small effects and inconsistent findings, so it does not establish a single best reassurance method. The Prevent Trial results were not yet published when the paper was written. Some recommendations are based on models and cited evidence rather than a new trial of reassurance.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that reassurance works by giving patients a normal test result or a comforting phrase. The paper reports that negative diagnostic tests did not reliably reduce fear or concern, and reassurance can increase concern.