Patients’ expectations of acute low back pain management: implications for evidence uptake

Hoffmann, Tammy C., Del Mar, Chris B., Strong, Jenny and Mai, Juliana (2013) Patients’ expectations of acute low back pain management: implications for evidence uptake. BMC Family Practice, 14 7.1-7.6. doi:10.1186/1471-2296-14-7

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Author Hoffmann, Tammy C.
Del Mar, Chris B.
Strong, Jenny
Mai, Juliana
Title Patients’ expectations of acute low back pain management: implications for evidence uptake
Journal name BMC Family Practice   Check publisher's open access policy
ISSN 1471-2296
Publication date 2013-01
Sub-type Article (original research)
DOI 10.1186/1471-2296-14-7
Open Access Status DOI
Volume 14
Start page 7.1
End page 7.6
Total pages 6
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2014
Language eng
Formatted abstract
Background: In many countries, general practitioner (GP) care of acute low back pain often does not adhere to evidence-based clinical guidelines. There has been little exploration of this deviation from evidence-based care from the patients’ perspective, particularly in relation to patients’ care expectations. The aim of this study was to explore the care expectations in patients who present to their GP with acute low back pain, influences on expectation development, and congruence of these expectations with clinical guideline recommendations.
Methods: Qualitative study in an inner urban general practice in Brisbane, Australia. Semi-structured interviews were conducted with 11 patients who presented to their GP with acute low back pain.
Results: Patients had a biomechanical understanding of back pain, how it should be tested and treated, and a poor understanding of its natural history. Most expected x-rays, believing they were necessary to identify the “cause of the pain” without belief of any downsides to x-rays. Patients’ expectations were primarily influenced by the experiences of family and friends, their own previous experiences of low back pain care, and comments from other health professionals they were consulting. The GP-patient relationship was important in influencing patient satisfaction of care provided. Most patient expectations, and some of the care that they reported receiving, were incongruent with guideline recommendations.
Conclusions: A biomechanical approach to management rather than an awareness of empirical evidence was evident in patients’ expectations. Communication and education by the GP that includes specifically enquiring about patients’ expectations, provides an opportunity to correct misperceptions, explain acute low back pain natural history, and the rationale for test and treatment recommendations.
Keyword Low back pain
Doctor-patient communication
Patient expectations
Clinical practice guidelines
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article # 7

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 7 times in Scopus Article | Citations
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Created: Thu, 10 Jan 2013, 12:19:10 EST by Professor Jenny Strong on behalf of School of Health & Rehabilitation Sciences