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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Patients’ experiences of the management of lower back pain in general practice: use of diagnostic imaging, medication and provision of self-management advice

Mariko Carey A B G , Heidi Turon A B , Stacy Goergen C D , Rob Sanson-Fisher A B , Sze Lin Yoong A F and Kay Jones E
+ Author Affiliations
- Author Affiliations

A Priority Research Centre for Health Behaviour, Faculty of Health, University of Newcastle, W4 HMRI Building, Callaghan, NSW 2308, Australia.

B Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW 2305, Australia.

C Department of Diagnostic Imaging, Southern Health, 246 Clayton Road, Clayton, Vic. 3168, Australia.

D School of Clinical Sciences at Monash Health, Monash Medical Centre, Block E, Level 5, 246 Clayton Road, Clayton, Vic. 3168, Australia.

E Office of Pro-Vice Chancellor, Monash University, Peninsula Campus, Building D, McMahons Road, Frankston, Vic. 3199, Australia.

F University of Newcastle, c/o Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia.

G Corresponding author. Email: Mariko.Carey@newcastle.edu.au

Australian Journal of Primary Health 21(3) 342-346 https://doi.org/10.1071/PY14057
Submitted: 25 March 2014  Accepted: 16 June 2014   Published: 30 July 2014

Abstract

Lower back pain is prevalent in the general community. Guidelines recommend against the use of diagnostic imaging unless ‘red flags’ are present that may indicate a potentially serious cause. This paper reports on a cross-sectional electronic survey to investigate self-reported experiences of lower back pain management among Australian general practice patients. Of the 872 participants, 551 (63%) reported that they had experienced lower back pain in the past 12 months. Approximately 40% of patients who had experienced lower back pain reported that they had consulted their general practitioner (GP) regarding this issue. Among those who sought general practice care, 67% reported being referred for diagnostic imaging. Those who received imaging were more likely to have been prescribed medication by their GP, but received self-management advice at the same rate as those who had not been referred. Rates of self-reported referral for diagnostic imaging were higher than expected, given the low prevalence of potentially serious causes for lower back pain reported in the international literature. However, it remains unclear whether this is due to poor guideline adherence by GPs or lack of specificity in the red flags identified in guidelines. Findings suggest the need for improvements in the provision of evidence-based self-management advice.

Additional keywords: cross-sectional survey, guideline adherence, patient management, prevalence, primary care.


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