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Orthopaedists' and family practitioners' knowledge of simple low back pain management.

Abstract：

STUDY DESIGN:Comparative knowledge survey. OBJECTIVE:This study compared the knowledge of orthopaedic surgeons and family practitioners in managing simple low back pain (LBP) with reference to currently published guidelines. SUMMARY OF BACKGROUND DATA:LBP is the most prevalent of musculoskeletal conditions. It affects nearly everyone at some point in time and about 4% to 33% of the population at any given point. Treatment guidelines for LBP should be based on evidence-based medicine and updated to improve patient management and outcome. Studies in various fields have assessed the impact of publishing guidelines on patient management, but little is known about the physicians' knowledge of the guidelines. METHODS:Orthopedic surgeons and family practitioners participating in their annual professional meetings were requested to answer a questionnaire regarding the management of simple low back pain. Answers were scored based on the national guidelines for management of low back pain. RESULTS:One hundred forty family practitioners and 253 orthopaedists responded to the questionnaire. The mean family practitioners' score (69.7) was significantly higher than the orthopaedists' score (44.3) (P < 0.0001). No relation was found between the results and physician demographic factors, including seniority. Most orthopaedists incorrectly responded that they would send their patients for radiologic evaluations. They would also preferentially prescribe cyclo-oxygenase-2-specific nonsteroidal anti-inflammatory drugs, despite the guidelines recommendations to use paracetamol or nonspecific nonsteroidal anti-inflammatory drugs. Significantly less importance was attributed to patient encouragement and reassurance by the orthopaedists as compared with family physicians. CONCLUSION:Both orthopaedic surgeons' and family physicians' knowledge of treating LBP is deficient. Orthopedic surgeons are less aware of current treatment than family practitioners. Although the importance of publishing guidelines and keeping them up-to-date and relevant for different disciplines in different countries cannot be overstressed, disseminating the knowledge to clinicians is also very important to ensure good practice.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Finestone AS,Raveh A,Mirovsky Y,Lahad A,Milgrom C

doi

10.1097/BRS.0b013e3181a96622

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

1600-3

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-200907010-00014

journal_volume

pub_type

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Orthopaedists' and family practitioners' knowledge of simple low back pain management.