Outcome domains of patient-reported outcome measures used in randomised controlled trials for older adults with non-specific low back pain: a systematic review

Objective
To summarise outcome domains and patient-reported outcome measures used in randomised controlled trials involving older adults with non-specific low back pain.

Methods
Seven databases were searched from inception to January 2025. Two independent reviewers screened articles, extracted data and categorised patient-reported outcome measures into outcome domains using the Dodd et al. 38-item framework, where pain outcomes for non-specific pain are classified as ‘general outcome’, which we have relabelled as ‘pain’ for clarity. Frequencies of patient-reported outcome measure use and domain coverage were analysed. Adherence to core outcome set domains (physical functioning, pain and health-related quality of life) and core outcome measurement set for non-specific low back pain was evaluated.

Results
From 57 included trials, 74 patient-reported outcome measures were identified across nine outcome domains. Physical functioning (n=80, 36%) and pain (n=57, 26%) were the most frequently assessed. The most frequently used patient-reported outcome measures were the Roland–Morris Disability Questionnaire and the Visual Analogue Scale. Measures for physical functioning, pain and health-related quality of life were used in 91%, 86% and 23% of studies, respectively. Only 14% addressed all three-core outcome set domains; none adhered fully to the core outcome measurement set.

Conclusions
Trials involving older adults with non-specific low back pain mainly evaluated pain and physical functioning, with limited coverage of other patient-centred domains. Future research should prioritise: (i) standardising outcome measurement with valid, reliable and responsive instruments; and (ii) developing and validating comprehensive, multi-domain outcome measures.

Contributors

Tony S H Chiu, Jae Q J Liu, Edmond C M Wong, Jeffrey C Y Ng, Alessandro Chiarotto, Katie de Luca, Richard Xu, Fabianna de Jesus-Moraleida, Manuela L Ferreira, Arnold Y L Wong

Publication

Journal: Age and Ageing
Volume: 55
Issue: 5
Pages: -
Year: 2026
DOI: https://doi.org/10.1093/ageing/afag116

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This work was supported by The Hong Kong Polytechnic University Department of Rehabilitation Sciences Fund (number: 4-ZZ4X)


Health Area

Disease Category: Orthopaedics & trauma

Disease Name: Low back pain

Target Population

Age Range: 60 - 120

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

Study Type

- COS uptake study
- Systematic review of outcomes measured in trials

Method(s)

- Systematic review