"You feel so hopeless": A qualitative study of GP management of acute back pain

This source preferred by Alan Breen

Authors: Austin, H., Breen, A.C., Campion-Smith, C., Carr, E.C.J. and Mann, E.

Journal: European Journal of Pain

Volume: 11

Pages: 21-29

ISSN: 1090-3801

DOI: 10.1016/j.ejpain.2005.12.006

Background Biopsychosocial management of non-specific back pain in general practice has been problematical, with frequent inappropriate referral for imaging and secondary care interventions and lack of self-confidence in the ability to provide evidence-based care.

Aims To examine GP attitudes to managing back pain as a biopsychosocial problem in order to inform future educational strategies that may improve practice.

Methods Twenty-one GPs from separate practices within the Dorset and Somerset Strategic Health Authority area (UK) participated in telephone interviews leading to the development of vignettes to refine the theoretical framework for subsequent focus group interviews about evidence-based back pain management. Transcripts were analysed thematically.

Results There were 5 main emergent themes. These were generally negative and dominated by concerns about doctor–patient interaction. They included feelings of frustration, mismatches of perceptions in the doctor–patient relationship, problems in relation to time, challenges and discord between stakeholders in the process (for example, over sickness certification) and a lack of resources for education, awareness and local services to refer to. Psychosocial aspects of the actual care process were rarely raised. Participants favoured education that is multidisciplinary, in small group format and involves the participation of patients.

Conclusions This study illustrates the difficulties that GPs may have in applying the relevant evidence for the successful management of back pain. A desire to avoid conflict in the relationship with patients explained much of the problem of implementing evidence in general practice. This indicates a need for insightful educational strategies that involve active GP participation.

Keywords: Back pain; General practice; Biopsychosocial model; Qualitative research

This data was imported from PubMed:

Authors: Breen, A., Austin, H., Campion-Smith, C., Carr, E. and Mann, E.

Journal: Eur J Pain

Volume: 11

Issue: 1

Pages: 21-29

ISSN: 1090-3801

DOI: 10.1016/j.ejpain.2005.12.006

BACKGROUND: Biopsychosocial management of non-specific back pain in general practice has been problematical, with frequent inappropriate referral for imaging and secondary care interventions and lack of self-confidence in the ability to provide evidence-based care. AIMS: To examine GP attitudes to managing back pain as a biopsychosocial problem in order to inform future educational strategies that may improve practice. METHODS: Twenty-one GPs from separate practices within the Dorset and Somerset Strategic Health Authority area (UK) participated in telephone interviews leading to the development of vignettes to refine the theoretical framework for subsequent focus group interviews about evidence-based back pain management. Transcripts were analysed thematically. RESULTS: There were 5 main emergent themes. These were generally negative and dominated by concerns about doctor-patient interaction. They included feelings of frustration, mismatches of perceptions in the doctor-patient relationship, problems in relation to time, challenges and discord between stakeholders in the process (for example, over sickness certification) and a lack of resources for education, awareness and local services to refer to. Psychosocial aspects of the actual care process were rarely raised. Participants favoured education that is multidisciplinary, in small group format and involves the participation of patients. CONCLUSIONS: This study illustrates the difficulties that GPs may have in applying the relevant evidence for the successful management of back pain. A desire to avoid conflict in the relationship with patients explained much of the problem of implementing evidence in general practice. This indicates a need for insightful educational strategies that involve active GP participation.

This data was imported from Scopus:

Authors: Breen, A., Austin, H., Campion-Smith, C., Carr, E. and Mann, E.

Journal: European Journal of Pain

Volume: 11

Issue: 1

Pages: 21-29

eISSN: 1532-2149

ISSN: 1090-3801

DOI: 10.1016/j.ejpain.2005.12.006

Background: Biopsychosocial management of non-specific back pain in general practice has been problematical, with frequent inappropriate referral for imaging and secondary care interventions and lack of self-confidence in the ability to provide evidence-based care. Aims: To examine GP attitudes to managing back pain as a biopsychosocial problem in order to inform future educational strategies that may improve practice. Methods: Twenty-one GPs from separate practices within the Dorset and Somerset Strategic Health Authority area (UK) participated in telephone interviews leading to the development of vignettes to refine the theoretical framework for subsequent focus group interviews about evidence-based back pain management. Transcripts were analysed thematically. Results: There were 5 main emergent themes. These were generally negative and dominated by concerns about doctor-patient interaction. They included feelings of frustration, mismatches of perceptions in the doctor-patient relationship, problems in relation to time, challenges and discord between stakeholders in the process (for example, over sickness certification) and a lack of resources for education, awareness and local services to refer to. Psychosocial aspects of the actual care process were rarely raised. Participants favoured education that is multidisciplinary, in small group format and involves the participation of patients. Conclusions: This study illustrates the difficulties that GPs may have in applying the relevant evidence for the successful management of back pain. A desire to avoid conflict in the relationship with patients explained much of the problem of implementing evidence in general practice. This indicates a need for insightful educational strategies that involve active GP participation. © 2006 European Federation of Chapters of the International Association for the Study of Pain.

This data was imported from Web of Science (Lite):

Authors: Breen, A., Austin, H., Campion-Smith, C., Carr, E. and Mann, E.

Journal: EUROPEAN JOURNAL OF PAIN

Volume: 11

Issue: 1

Pages: 21-29

ISSN: 1090-3801

DOI: 10.1016/j.ejpain.2005.12.006

This data was imported from Europe PubMed Central:

Authors: Breen, A., Austin, H., Campion-Smith, C., Carr, E. and Mann, E.

Journal: European journal of pain (London, England)

Volume: 11

Issue: 1

Pages: 21-29

eISSN: 1532-2149

ISSN: 1090-3801

BACKGROUND: Biopsychosocial management of non-specific back pain in general practice has been problematical, with frequent inappropriate referral for imaging and secondary care interventions and lack of self-confidence in the ability to provide evidence-based care. AIMS: To examine GP attitudes to managing back pain as a biopsychosocial problem in order to inform future educational strategies that may improve practice. METHODS: Twenty-one GPs from separate practices within the Dorset and Somerset Strategic Health Authority area (UK) participated in telephone interviews leading to the development of vignettes to refine the theoretical framework for subsequent focus group interviews about evidence-based back pain management. Transcripts were analysed thematically. RESULTS: There were 5 main emergent themes. These were generally negative and dominated by concerns about doctor-patient interaction. They included feelings of frustration, mismatches of perceptions in the doctor-patient relationship, problems in relation to time, challenges and discord between stakeholders in the process (for example, over sickness certification) and a lack of resources for education, awareness and local services to refer to. Psychosocial aspects of the actual care process were rarely raised. Participants favoured education that is multidisciplinary, in small group format and involves the participation of patients. CONCLUSIONS: This study illustrates the difficulties that GPs may have in applying the relevant evidence for the successful management of back pain. A desire to avoid conflict in the relationship with patients explained much of the problem of implementing evidence in general practice. This indicates a need for insightful educational strategies that involve active GP participation.

The data on this page was last updated at 04:55 on April 21, 2019.