User Perspectives on Systematic Data Collection Regarding Back Pain Managed in General Practice - a Qualitative Study

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2022 Jul 19

PMID 35854291

Authors

Sarah Morgan

Alice Kongsted

Birgitte Norgaard

Affiliations

Soon will be listed here.

Abstract

Background: Back pain is a main driver of disability and the most prevalent reason why people in Demark visit a general practitioner (GP). However, little is known about back pain management in primary care. For new strategies to be sustainable and to accommodate the recommendations for evidence-based practice, patients' perspectives are paramount to complement clinical expertise and research evidence. This study aimed to identify recommendations for systematic data collection in a nationwide cohort regarding the management of back pain in general practice from the perspectives of GPs and patients.

Method: We applied an adapted exploratory sequential design using focus groups and individual interviews. Seven GPs and ten patients with back pain participated, and four focus groups and seventeen individual interviews were conducted. Data were analyzed using abductive reasoning.

Results: Both GPs and patients with back pain found that 1) recruitment to a cohort should take place through the GPs, 2) the heterogeneity of patients with back pain and their need for individualized treatment and care should be considered, and 3) data from the cohort should feed into a flowchart or guideline to illustrate a generic patient pathway and visually assist both the patient and GP to obtain an overview and, thus, structure the patient pathway.

Conclusion: GPs and patients with back pain both considered the nationwide cohort with the overall aim to investigate back pain management as being extremely relevant in relation to improve t the patient pathway. User perspectives should be explored and integrated into health care interventions.

References

Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M . What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2019; 54(2):79-86. DOI: 10.1136/bjsports-2018-099878. View

Fu Y, McNichol E, Marczewski K, Closs S . The Management of Chronic Back Pain in Primary Care Settings: Exploring Perceived Facilitators and Barriers to the Development of Patient-Professional Partnerships. Qual Health Res. 2018; 28(9):1462-1473. DOI: 10.1177/1049732318768229. View

Ahnfeldt-Mollerup P, Sondergaard J, Barwell F, Mazelan P, Spurgeon P, Kristensen T . The Relationships Between Use of Quality-of-Care Feedback Reports on Chronic Diseases and Medical Engagement in General Practice. Qual Manag Health Care. 2018; 27(4):191-198. PMC: 6166699. DOI: 10.1097/QMH.0000000000000188. View

Rossen C, Hoybye M, Jorgensen L, Bruun L, Hybholt L . Disrupted everyday life in the trajectory of low back pain: A longitudinal qualitative study of the cross-sectorial pathways of individuals with low back pain over time. Int J Nurs Stud Adv. 2024; 3:100021. PMC: 11080427. DOI: 10.1016/j.ijnsa.2021.100021. View

Satterfield J, Spring B, Brownson R, Mullen E, Newhouse R, Walker B . Toward a transdisciplinary model of evidence-based practice. Milbank Q. 2009; 87(2):368-90. PMC: 2698591. DOI: 10.1111/j.1468-0009.2009.00561.x. View

Hill J, Whitehurst D, Lewis M, Bryan S, Dunn K, Foster N . Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011; 378(9802):1560-71. PMC: 3208163. DOI: 10.1016/S0140-6736(11)60937-9. View

Andersen M, Bowen D, Morea J, Stein K, Baker F . Involvement in decision-making and breast cancer survivor quality of life. Health Psychol. 2009; 28(1):29-37. DOI: 10.1037/0278-6133.28.1.29. View

Noor Abdulhadi N, Al-Shafaee M, Wahlstrom R, Hjelm K . Doctors' and nurses' views on patient care for type 2 diabetes: an interview study in primary health care in Oman. Prim Health Care Res Dev. 2012; 14(3):258-69. PMC: 3682753. DOI: 10.1017/S146342361200062X. View

Sacristan J, Aguaron A, Avendano-Sola C, Garrido P, Carrion J, Gutierrez A . Patient involvement in clinical research: why, when, and how. Patient Prefer Adherence. 2016; 10:631-40. PMC: 4854260. DOI: 10.2147/PPA.S104259. View

10.

Fu Y, McNichol E, Marczewski K, Closs S . Patient-professional partnerships and chronic back pain self-management: a qualitative systematic review and synthesis. Health Soc Care Community. 2015; 24(3):247-59. DOI: 10.1111/hsc.12223. View

11.

Slade S, Kent P, Patel S, Bucknall T, Buchbinder R . Barriers to Primary Care Clinician Adherence to Clinical Guidelines for the Management of Low Back Pain: A Systematic Review and Metasynthesis of Qualitative Studies. Clin J Pain. 2015; 32(9):800-16. DOI: 10.1097/AJP.0000000000000324. View

12.

Buchbinder R, van Tulder M, Oberg B, Costa L, Woolf A, Schoene M . Low back pain: a call for action. Lancet. 2018; 391(10137):2384-2388. DOI: 10.1016/S0140-6736(18)30488-4. View

13.

Espeland A, Baerheim A . Factors affecting general practitioners' decisions about plain radiography for back pain: implications for classification of guideline barriers--a qualitative study. BMC Health Serv Res. 2003; 3(1):8. PMC: 153534. DOI: 10.1186/1472-6963-3-8. View

14.

Ansmann L, Pfaff H . Providers and Patients Caught Between Standardization and Individualization: Individualized Standardization as a Solution Comment on "(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare". Int J Health Policy Manag. 2018; 7(4):349-352. PMC: 5949226. DOI: 10.15171/ijhpm.2017.95. View

15.

Watanabe Y, Takahashi M, Kai I . Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study. BMC Public Health. 2008; 8:77. PMC: 2291463. DOI: 10.1186/1471-2458-8-77. View

16.

Due T, Thorsen T, Brostrom Kousgaard M, Siersma V, Waldorff F . The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice: a stepped-wedge randomised controlled trial. BMC Fam Pract. 2014; 15:65. PMC: 4234362. DOI: 10.1186/1471-2296-15-65. View

17.

Kongsted A, Kent P, Axen I, Downie A, Dunn K . What have we learned from ten years of trajectory research in low back pain?. BMC Musculoskelet Disord. 2016; 17:220. PMC: 4875630. DOI: 10.1186/s12891-016-1071-2. View

18.

Hall A, Scurrey S, Pike A, Albury C, Richmond H, Matthews J . Physician-reported barriers to using evidence-based recommendations for low back pain in clinical practice: a systematic review and synthesis of qualitative studies using the Theoretical Domains Framework. Implement Sci. 2019; 14(1):49. PMC: 6505266. DOI: 10.1186/s13012-019-0884-4. View

19.

Titlestad S, Marcussen M, Rasmussen M, Norgaard B . Patient involvement in the encounter between general practice and patients with a chronic disease. Results of a scoping review focusing on type 2 diabetes and obstructive pulmonary disease. Eur J Gen Pract. 2022; 28(1):260-269. PMC: 9754033. DOI: 10.1080/13814788.2022.2153827. View

20.

Ernst J, Kuhnt S, Schwarzer A, Aldaoud A, Niederwieser D, Mantovani-Loffler L . The desire for shared decision making among patients with solid and hematological cancer. Psychooncology. 2010; 20(2):186-93. DOI: 10.1002/pon.1723. View