Manual Therapy by General Medical Practitioners for Nonspecific Low Back Pain in Primary Care: The ManRück Study Protocol of a Clinical Trial

Abstract Background Imaging is overused in the management of low back pain and effective interventions to decrease use have not been developed. An intervention, incorporating a low back pain management booklet and practitioner training session, to reduce non-indicated imaging for low back pain has been developed based on theories of behaviour change. This study aimed to explore general medical practitioner experiences using the low back pain management booklet in clinical practice to 1) determine the adoption, feasibility of use, and appropriateness of the booklet; and 2) identify implementation strategies to address barriers to use.Methods Fourteen general medical practitioners were recruited and trained to use the booklet with low back pain patients over a minimum five-month period. Quantitative data on use of the booklet were collected and analysed descriptively. Qualitative data were collected in general medical practitioner interviews and thematically analysed. Barriers to use were identified and mapped to suitable implementation strategies using the Behaviour Change Wheel. Results The 14 general medical practitioners used the booklet with 73 patients. General medical practitioners thought using the booklet helped improve patient management and helped reduce pressure to refer for non-indicated imaging. Facilitators for using the booklet included patient’s requesting imaging and lower practitioner confidence in managing low back pain. Barriers included accessible storage and remembering to use the booklet. Implementation strategies were identified to increase adoption and feasibility of use, including development of a digital version of the booklet.Conclusions General medical practitioners reported that the low back pain management booklet was useful for clinical practice, particularly with patients requesting imaging. Barriers to use were identified and implementation strategies to address these barriers will be incorporated into future effectiveness studies. This study forms one of a series of studies to develop and test an intervention to reduce non-indicated imaging for low back pain; a successful intervention would decrease healthcare costs and improve patient management.

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General Practitioner Experiences Using a Low Back Pain Management Booklet Aiming to Decrease Non-indicated Imaging for Low Back Pain

10.21203/rs.3.rs-65375/v1 ◽

2020 ◽

Author(s):

Hazel J Jenkins ◽

Niamh A Moloney ◽

Simon D French ◽

Chris G Maher ◽

Blake F Dear ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Management ◽

Implementation Strategies ◽

Low Back ◽

General Medical Practitioner ◽

Medical Practitioners ◽

Barriers To Use ◽

General Medical Practitioners ◽

Back Pain Management

Abstract Background Imaging is overused in the management of low back pain and effective interventions to decrease use have not been developed. An intervention, incorporating a low back pain management booklet and practitioner training session, to reduce non-indicated imaging for low back pain has been developed based on theories of behaviour change. This study aimed to explore general medical practitioner experiences using the low back pain management booklet in clinical practice to 1) determine the adoption, feasibility of use, and appropriateness of the booklet; and 2) identify implementation strategies to address barriers to use.Methods Fourteen general medical practitioners were recruited and trained to use the booklet with low back pain patients over a minimum five-month period. Quantitative data on use of the booklet were collected and analysed descriptively. Qualitative data were collected in general medical practitioner interviews and thematically analysed. Barriers to use were identified and mapped to suitable implementation strategies using the Behaviour Change Wheel. Results The 14 general medical practitioners used the booklet with 73 patients. General medical practitioners thought using the booklet helped improve patient management and helped reduce pressure to refer for non-indicated imaging. Facilitators for using the booklet included patient’s requesting imaging and lower practitioner confidence in managing low back pain. Barriers included accessible storage and remembering to use the booklet. Implementation strategies were identified to increase adoption and feasibility of use, including development of a digital version of the booklet.Conclusions General medical practitioners reported that the low back pain management booklet was useful for clinical practice, particularly with patients requesting imaging. Barriers to use were identified and implementation strategies to address these barriers will be incorporated into future effectiveness studies. This study forms one of a series of studies to develop and test an intervention to reduce non-indicated imaging for low back pain; a successful intervention would decrease healthcare costs and improve patient management.

Download Full-text