Management of acute low back pain: the practices and perspectives of primary care clinicians in Australia
Malene Ahern
A E , Catherine M. Dean A , Blake F. Dear B C , Simon M. Willcock D and Julia M. Hush A
A Faculty of Medicine, Health and Human Sciences, Macquarie University, Level 3, 75 Talavera Road, Sydney, NSW 2109, Australia.
B eCentreClinic, Macquarie University, Sydney, NSW 2109, Australia.
C Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia
D Macquarie University Health Sciences Centre, Macquarie University, Suite 305, Level 3, 2 Technology Place, Sydney, NSW 2109, Australia.
E Corresponding author. Email: malene.ahern@hdr.mq.edu.au
Australian Journal of Primary Health 26(3) 256-264 https://doi.org/10.1071/PY19152
Submitted: 29 July 2019 Accepted: 3 March 2020 Published: 12 June 2020
Abstract
Low back pain (LBP) is the highest cause of years lived with a disability in Australia and the most frequent musculoskeletal condition for which patients seek primary care. The aims of this study were to: (1) evaluate the current practices and perspectives of Australian GPs and physiotherapists managing acute back pain; and (2) explore alignment of care with clinical guidelines. This was a prospective cross-sectional Internet survey conducted from March 2018 to May 2018 of experienced Australian GPs and physiotherapists. Descriptive statistics were used to analyse all quantitative outcomes. Two hundred primary care practitioners (72% physiotherapists and 28% GPs) from all States and Territories of Australia completed the survey. Most primary care practitioners were familiar with clinical guidelines for acute back pain management and reported delivery of many of the core components of guideline-based care, including education, advice about favourable prognosis, encouraging activity and self-management and discouraging prolonged bed rest. Deviations from guideline-based care were common, including provision of analgesic medication, passive therapies and using radiological imaging. Australian primary care clinicians in this sample were aware of back pain guidelines and typically implement care that is consistent with guideline-based recommendations. Divergences from these guidelines may indicate that primary care practitioners are delivering evidence-based and person-centred care that integrates clinicians’ judgement with patients’ preferences and guideline-based evidence.
Additional keywords: delivery of health care, evidence-based practice, person-centred care, primary health care.
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