Patients' expectations of acute low back pain management: implications for evidence uptake.

Abstract:

BACKGROUND:In many countries, general practitioner (GP) care of acute low back pain often does not adhere to evidence-based clinical guidelines. There has been little exploration of this deviation from evidence-based care from the patients' perspective, particularly in relation to patients' care expectations. The aim of this study was to explore the care expectations in patients who present to their GP with acute low back pain, influences on expectation development, and congruence of these expectations with clinical guideline recommendations. METHODS:Qualitative study in an inner urban general practice in Brisbane, Australia. Semi-structured interviews were conducted with 11 patients who presented to their GP with acute low back pain. RESULTS:Patients had a biomechanical understanding of back pain, how it should be tested and treated, and a poor understanding of its natural history. Most expected x-rays, believing they were necessary to identify the "cause of the pain" without belief of any downsides to x-rays. Patients' expectations were primarily influenced by the experiences of family and friends, their own previous experiences of low back pain care, and comments from other health professionals they were consulting. The GP-patient relationship was important in influencing patient satisfaction of care provided. Most patient expectations, and some of the care that they reported receiving, were incongruent with guideline recommendations. CONCLUSIONS:A biomechanical approach to management rather than an awareness of empirical evidence was evident in patients' expectations. Communication and education by the GP that includes specifically enquiring about patients' expectations, provides an opportunity to correct misperceptions, explain acute low back pain natural history, and the rationale for test and treatment recommendations.

journal_name

BMC Fam Pract

journal_title

BMC family practice

authors

Hoffmann TC,Del Mar CB,Strong J,Mai J

doi

10.1186/1471-2296-14-7

subject

Has Abstract

pub_date

2013-01-08 00:00:00

pages

7

issn

1471-2296

pii

1471-2296-14-7

journal_volume

14

pub_type

杂志文章
  • Head of bed elevation to relieve gastroesophageal reflux symptoms: a systematic review.

    abstract:BACKGROUND:Overuse of proton pump inhibitors (PPIs) - frequently used for relieving symptoms of gastroesophageal reflux disease (GORD) - raises long-term safety concerns, warranting evidence-based non-drug interventions. We conducted a systematic review to evaluate the effect of head-of-bed elevation on relieving sympt...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-021-01369-0

    authors: Albarqouni L,Moynihan R,Clark J,Scott AM,Duggan A,Del Mar C

    更新日期:2021-01-19 00:00:00

  • When the phone rings - factors influencing its impact on the experience of patients and healthcare workers during primary care consultation: a qualitative study.

    abstract:BACKGROUND:In the primary health care setting, patients interact directly with their healthcare workers (HCW), which include their primary physicians, nurses and pharmacists. Studies have shown that such interactions, when interrupted by phone calls received by either party, can lead to adverse outcomes and negative ex...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0330-x

    authors: Koong AY,Koot D,Eng SK,Purani A,Yusoff A,Goh CC,Teo SS,Tan NC

    更新日期:2015-09-02 00:00:00

  • Implementing guidelines for depression on antidepressant prescribing in general practice: a quasi-experimental evaluation.

    abstract:BACKGROUND:Internationally, guidelines for depression recommend a stepped care approach, implying that antidepressant medication should not be offered as a first step treatment to patients with sub-threshold or mild depression. In the Netherlands, antidepressant prescribing rates in general practice as a first treatmen...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-15-35

    authors: Franx G,Huyser J,Koetsenruijter J,van der Feltz-Cornelis CM,Verhaak PF,Grol RP,Wensing M

    更新日期:2014-02-19 00:00:00

  • Emerging organisational models of primary healthcare and unmet needs for care: insights from a population-based survey in Quebec province.

    abstract:BACKGROUND:Reform of primary healthcare (PHC) organisations is underway in Canada. The capacity of various types of PHC organizations to respond to populations' needs remains to be assessed. The main objective of this study was to evaluate the association of PHC affiliation with unmet needs for care. METHODS:Populatio...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-13-66

    authors: Levesque JF,Pineault R,Hamel M,Roberge D,Kapetanakis C,Simard B,Prud'homme A

    更新日期:2012-07-02 00:00:00

  • Irish general practitioners' view of perinatal mental health in general practice: a qualitative study.

    abstract:BACKGROUND:Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-018-0884-5

    authors: Noonan M,Doody O,O'Regan A,Jomeen J,Galvin R

    更新日期:2018-12-13 00:00:00

  • Deprescribing medication in very elderly patients with multimorbidity: the view of Dutch GPs. A qualitative study.

    abstract:BACKGROUND:Elderly patients with multimorbidity who are treated according to guidelines use a large number of drugs. This number of drugs increases the risk of adverse drug events (ADEs). Stopping medication may relieve these effects, and thereby improve the patient's wellbeing. To facilitate management of polypharmacy...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-13-56

    authors: Schuling J,Gebben H,Veehof LJ,Haaijer-Ruskamp FM

    更新日期:2012-07-09 00:00:00

  • An unusual case of chronic meningitis.

    abstract:BACKGROUND:Chronic meningitis is defined as symptoms and signs of meningeal inflammation and persisting cerebrospinal fluid abnormalities such as elevated protein level and pleocytosis for at least one month. CASE PRESENTATION:A 62-year-old woman, of unremarkable past medical history, was admitted to hospital for inve...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-5-21

    authors: Boos C,Daneshvar C,Hinton A,Dawes M

    更新日期:2004-10-06 00:00:00

  • Heart failure labelled patients with missing ejection fraction in primary care: prognosis and determinants.

    abstract:BACKGROUND:It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it register...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-017-0612-6

    authors: Muñoz MA,Mundet-Tuduri X,Real J,Del Val JL,Domingo M,Vinyoles E,Calero E,Checa C,Soldevila-Bacardit N,Verdú-Rotellar JM

    更新日期:2017-03-17 00:00:00

  • Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis.

    abstract:BACKGROUND:A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mo...

    journal_title:BMC family practice

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s12875-015-0314-x

    authors: Linde K,Rücker G,Sigterman K,Jamil S,Meissner K,Schneider A,Kriston L

    更新日期:2015-08-19 00:00:00

  • Clinical prediction rules combining signs, symptoms and epidemiological context to distinguish influenza from influenza-like illnesses in primary care: a cross sectional study.

    abstract:BACKGROUND:During an influenza epidemic prompt diagnosis of influenza is important. This diagnosis however is still essentially based on the interpretation of symptoms and signs by general practitioners. No single symptom is specific enough to be useful in differentiating influenza from other respiratory infections. Ou...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-12-4

    authors: Michiels B,Thomas I,Van Royen P,Coenen S

    更新日期:2011-02-09 00:00:00

  • A systematic review of approaches to improve practice, detection and treatment of unhealthy alcohol use in primary health care: a role for continuous quality improvement.

    abstract:BACKGROUND:Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. T...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-1101-x

    authors: Dzidowska M,Lee KSK,Wylie C,Bailie J,Percival N,Conigrave JH,Hayman N,Conigrave KM

    更新日期:2020-02-13 00:00:00

  • General practitioners' views on polypharmacy and its consequences for patient health care.

    abstract:BACKGROUND:Multimorbidity is defined as suffering from coexistent chronic conditions. Multimorbid patients demand highly complex patient-centered care which often includes polypharmacy, taking an average of six different drugs per day. Adverse drug reactions, adverse drug events and medication errors are all potential ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-14-119

    authors: Köberlein J,Gottschall M,Czarnecki K,Thomas A,Bergmann A,Voigt K

    更新日期:2013-08-15 00:00:00

  • Feasibility and effectiveness of the implementation of a primary prevention programme for type 2 diabetes in routine primary care practice: a phase IV cluster randomised clinical trial.

    abstract:BACKGROUND:The objective of this study is to perform an independent evaluation of the feasibility and effectiveness of an educational programme for the primary prevention of type 2 diabetes (DM2) in high risk populations in primary care settings, implanted within the Basque Health Service - Osakidetza. METHODS/DESIGN:...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-13-109

    authors: Sanchez A,Silvestre C,Sauto R,Martínez C,Grandes G,PreDE research group.

    更新日期:2012-11-16 00:00:00

  • 'Very brief advice' (VBA) on smoking in family practice: a qualitative evaluation of the tobacco user's perspective.

    abstract:BACKGROUND:Very Brief Advice on smoking (VBA) is an evidence-based intervention designed to increase quit attempts among patients who smoke. VBA has been widely disseminated in general practice settings in the United Kingdom, however its transferability to Southern European settings is not well established. This study ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01195-w

    authors: Papadakis S,Anastasaki M,Papadakaki M,Antonopoulou Μ,Chliveros C,Daskalaki C,Varthalis D,Triantafyllou S,Vasilaki I,McEwen A,Lionis C

    更新日期:2020-06-24 00:00:00

  • How do older adults understand and manage distress? A qualitative study.

    abstract:BACKGROUND:Distress is an expected emotional response to a negative life event. Experiences common in later life may trigger distress such as bereavement or loss of physical mobility. Distress is considered to be distinct to anxiety and/or depression and is not diagnostically labelled as a mental health problem. Older ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01152-7

    authors: Moult A,Kingstone T,Chew-Graham CA

    更新日期:2020-05-04 00:00:00

  • Prescribing style and variation in antibiotic prescriptions for sore throat: cross-sectional study across six countries.

    abstract:BACKGROUND:Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescr...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0224-y

    authors: Cordoba G,Siersma V,Lopez-Valcarcel B,Bjerrum L,Llor C,Aabenhus R,Makela M

    更新日期:2015-01-29 00:00:00

  • Patient and general practitioner attitudes to taking medication to prevent cardiovascular disease after receiving detailed information on risks and benefits of treatment: a qualitative study.

    abstract:BACKGROUND:There are now effective drugs to prevent cardiovascular disease and guidelines recommend their use. Patients do not always choose to accept preventive medication at levels of risk reduction recommended in guidelines. The purpose of the study was to identify and explore the attitudes of patients and general p...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-12-59

    authors: Gale NK,Greenfield S,Gill P,Gutridge K,Marshall T

    更新日期:2011-06-26 00:00:00

  • Treatment of urinary tract infections in Swiss primary care: quality and determinants of antibiotic prescribing.

    abstract:BACKGROUND:Urinary tract infections are one of the most common reasons for prescribing antibiotics in primary care. Current guidelines recommend fosfomycin, nitrofurantoin, or trimethoprim - sulfamethoxazol as empiric first line antimicrobial agents in uncomplicated infections. However, there is evidence that the use o...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01201-1

    authors: Plate A,Kronenberg A,Risch M,Mueller Y,Di Gangi S,Rosemann T,Senn O

    更新日期:2020-07-01 00:00:00

  • The developing family doctor system: evidence from the progress of the family doctor signing service from a longitudinal survey (2013-2016) in Pudong New Area, Shanghai.

    abstract:BACKGROUND:The family doctor system is a vital part of China's national medical and health system reform. Evidence of the degree of implementation of the family doctor system is required to assist managers and policy makers in Pudong with resource allocation planning. This study analyzed changes in indicators (family d...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01353-0

    authors: Liu S,Liu Y,Zhang T,Wang L,Huang J,Liang H,Chen G,Liu C,Zhang Y

    更新日期:2021-01-08 00:00:00

  • Evaluation of the quality of care of a multi-disciplinary Risk Factor Assessment and Management Programme for Hypertension (RAMP-HT).

    abstract:BACKGROUND:There is some evidence to support a risk-stratified, multi-disciplinary approach to manage patients with hypertension in primary care. The aim of this study is to evaluate the quality of care (QOC) of a multi-disciplinary Risk Assessment and Management Programme for Hypertension (RAMP-HT) for hypertensive pa...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0291-0

    authors: Yu EY,Wan EY,Chan KH,Wong CK,Kwok RL,Fong DY,Lam CL

    更新日期:2015-06-19 00:00:00

  • Public preferences for primary care provision in Germany - a discrete choice experiment.

    abstract:BACKGROUND:Primary care is a central element of healthcare and addresses the main health problems of the population. While primary care gains in importance due to an aging population, there is an ongoing debate on physician shortages in German rural regions. The study aims on analyzing the population's preferences on p...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-019-0967-y

    authors: Krinke KS,Tangermann U,Amelung VE,Krauth C

    更新日期:2019-06-11 00:00:00

  • Evidence for deprescription in primary care through an umbrella review.

    abstract:BACKGROUND:There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effe...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01166-1

    authors: Olry de Labry Lima A,Marcos Marcos J,Marquina Marquez A,González Vera MLÁ,Matas Hoces A,Bermúdez Tamayo C

    更新日期:2020-06-08 00:00:00

  • Understanding the work of general practitioners: a social science perspective on the context of medical decision making in primary care.

    abstract:BACKGROUND:The work of general practitioners (GPs) is increasingly being looked at from the perspective of the strategies and factors shaping it. This reflects the importance given to primary care services in health care system reform. However, the literature provides little insight into the medical decision-making pro...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-9-12

    authors: Geneau R,Lehoux P,Pineault R,Lamarche P

    更新日期:2008-02-19 00:00:00

  • Dying at home in Belgium: a descriptive GP interview study.

    abstract:BACKGROUND:While increasing attention is being paid to enabling terminal patients to remain at home until death, limited information is available on the circumstances in which people at home actually die. Therefore this study aims to describe patient characteristics, functional and cognitive status and physical and psy...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-13-4

    authors: Leemans K,Van den Block L,Bilsen J,Cohen J,Boffin N,Deliens L

    更新日期:2012-01-19 00:00:00

  • Women with symptoms of uncomplicated urinary tract infection are often willing to delay antibiotic treatment: a prospective cohort study.

    abstract:BACKGROUND:Women presenting with symptoms of acute uncomplicated urinary tract infection (UTI) are often prescribed antibiotics. However, in 25 to 50% of symptomatic women not taking antibiotics, symptoms recover spontaneously within one week. It is not known how many women are prepared to delay antibiotic treatment. W...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-14-71

    authors: Knottnerus BJ,Geerlings SE,Moll van Charante EP,ter Riet G

    更新日期:2013-05-31 00:00:00

  • Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study.

    abstract:BACKGROUND:Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. METHODS:We used a novel priority-setting method for i...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-016-0552-6

    authors: Tudor Car L,Papachristou N,Gallagher J,Samra R,Wazny K,El-Khatib M,Bull A,Majeed A,Aylin P,Atun R,Rudan I,Car J,Bell H,Vincent C,Franklin BD

    更新日期:2016-11-16 00:00:00

  • The definition of disabling fatigue in children and adolescents.

    abstract:BACKGROUND:Disabling fatigue is the main illness related reason for prolonged absence from school. Although there are accepted criteria for diagnosing chronic fatigue in adults, it remains uncertain as to how best to define disabling fatigue and Chronic Fatigue Syndrome (CFS) in children and adolescents. In this popula...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-6-33

    authors: Fowler T,Duthie P,Thapar A,Farmer A

    更新日期:2005-08-09 00:00:00

  • The RISAP-study: a complex intervention in risk communication and shared decision-making in general practice.

    abstract:BACKGROUND:General practitioners (GPs) and patients find it difficult to talk about risk of future disease, especially when patients have asymptomatic conditions, and treatment options are unlikely to cause immediate perceptible improvements in well-being. Further studies in risk communication training are needed. AIM...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-11-70

    authors: Kirkegaard P,Edwards AG,Hansen B,Hansen MD,Jensen MS,Lauritzen T,Risoer MB,Thomsen JL

    更新日期:2010-09-22 00:00:00

  • The value of signs, symptoms and plasma heart-type fatty acid-binding protein (H-FABP) in evaluating patients presenting with symptoms possibly matching acute coronary syndrome: background and methods of a diagnostic study in primary care.

    abstract:BACKGROUND:Chest complaints presented to a general practitioner (GP) are frequently caused by diseases which have advantageous outcomes. However, in some cases, acute coronary syndrome (ACS) is present (1.5-22% of cases). The patient's signs, symptoms and electrocardiography results are insufficient diagnostic tools to...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-014-0203-8

    authors: Willemsen RT,Buntinx F,Winkens B,Glatz JF,Dinant GJ,‘RAPIDA’-study team.

    更新日期:2014-12-12 00:00:00

  • Identifying patients with medically unexplained physical symptoms in electronic medical records in primary care: a validation study.

    abstract:BACKGROUND:When medically unexplained physical symptoms (MUPS) become persistent, it may have major implications for the patient, the general practitioner (GP) and for society.Early identification of patients with MUPS in electronic medical records (EMRs) might contribute to prevention of persistent MUPS by creating aw...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-15-109

    authors: den Boeft M,van der Wouden JC,Rydell-Lexmond TR,de Wit NJ,van der Horst HE,Numans ME

    更新日期:2014-06-05 00:00:00