Evidence-based development of a post-surgical lumbar discectomy leaflet intervention: a Delphi consensus study

OBJECTIVE To produce free, expert-informed postoperative information for lumbar discectomy patients, satisfying UK National Health Service Information Standards. DESIGN A mixed methods approach utilising the Delphi technique and focus groups. SETTING Five spinal centres across the UK. PARTICIPANTS Panel members included 23 physiotherapists, 11 patients and 17 spinal surgeons. INTERVENTION Three rounds of questionnaires including open and closed questions and attendance at a clinician/patient focus group. RESULTS Response rates of 85%, 26% and 35% were achieved for the Delphi rounds. Ten clinicians and six patients participated in the focus groups. Consensus for leaflet sections was achieved in round 1 and content in round 3. The focus groups informed further revisions. CONCLUSIONS A consensually agreed, Information Standard compliant, patient lumbar discectomy leaflet was produced containing: (1) normal spine anatomy; (2) anatomy disc herniation and surgery; (3) back protection strategies and (4) frequently asked questions. Illustrations of exercises enable tailoring to the individual patient.