Emerg Med J 20:514-517 doi:10.1136/emj.20.6.514
  • Original Article

Evaluation of an evidence based patient educational booklet for management of whiplash associated disorders

  1. T McClune,
  2. A K Burton,
  3. G Waddell
  1. Spinal Research Unit, University of Huddersfield, Huddersfield, UK
  1. Correspondence to:
 Mr T McClune
 30 Queen Street, University of Huddersfield, Huddersfield HD1 2SP, UK;
  • Accepted 2 October 2002


Objectives: This study aimed to develop and evaluate an evidence based educational booklet on whiplash associated disorders.

Methods: A comprehensive review of the available scientific evidence produced a set of unambiguous patient centred messages that challenge unhelpful beliefs about whiplash and promote an active approach to recovery. These messages were incorporated into a novel booklet, which was then evaluated qualitatively for end user acceptability and its ability to impart the intended messages, and quantitatively for its ability to improve beliefs about whiplash and what to do about it. The subjects comprised people attending accident and emergency or manipulative practice with a whiplash associated disorder, along with a sample of workers without a whiplash associated disorder (n = 142).

Results: The qualitative results showed that the booklet was considered easy to read, understandable, believable, and conveyed its key messages. Quantitatively, it produced a substantial statistically significant improvement in beliefs about whiplash among accident and emergency patients (mean 6.5, 95% CI 3.9 to 9.1, p<0.001), and among workers (mean 9.4, 95% CI 7.9 to 10.9, p<0.001), but the shift in the more chronic manipulation patients was substantially smaller (mean 3.3, 95% CI 0.5 to 6.1, p<0.05).

Conclusions: A rigorously developed educational booklet on whiplash (The Whiplash Book) was found acceptable to patients, and capable of improving beliefs about whiplash and its management; it seems suitable for use in the accident and emergency environment, and for wider distribution at the population level. A randomised controlled trial would be required to determine whether it exerts an effect on behaviour and clinical outcomes.


  • Funding: The Association of British Insurers gave financial support for the literature review and development of the booklet, while The Stationery Office bore the publishing costs

  • Conflicts of interest: none declared