Abstract
OBJECTIVE: Clinical guidelines for managing low back pain (LBP) emphasise patient information, patient education and physical activity as key components. Little is known about who actually receives information. This study investigates to what extent information at the first consultation with general practitioner (GP), chiropractor (DC) and physiotherapist (PT) in Danish primary care is provided to patients with LBP.
DESIGN AND SETTING: This cross-sectorial study was conducted as a prospective survey registration of LBP consultations at the three primary health care professions in Denmark.
INTERVENTION: Clinicians ticked off a paper survey chart during or after consultations with patients who visited the clinic for LBP (Approval number: ID # 11.220).
SUBJECTS: 33 GPs, 43 DCs and 61 PTs registered first-time consultations.
MAIN OUTCOME MEASURES: The primary outcome was provision of information, overall and across care settings.
RESULTS: The overall proportion of patients provided with information was 72%, but this varied among professions (GP, 44%; DC, 76%; and PT, 74%). Provision of information increased to 78% if patients had increased emotional distress or back-related leg pain below the knee. The strongest association with provision of information was having two or three signs of elevated distress (OR 2.58 and 5.05, respectively, p= 0.00) or physical disability (OR 2.55, p= 0.00).
CONCLUSION: In more than a quarter of first-time consultations, patient information was not provided. Large variation in providing information was found across the settings. The proportion provided with information increased for sub-populations having elevated distress or back-related leg pain below the knee.Key Points Clinical guidelines recommend patient information, patient education and physical activity for managing low back pain (LBP) • Information is not provided in more than a quarter of first-time consultations in Danish primary care settings that manage these patients. • Information increased for the sub-populations having elevated distress and back-related leg pain below the knee. • The conducted primary care surveys monitored clinical activity and illustrated variations in provision of information.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Scandinavian Journal of Primary Health Care |
| Vol/bind | 40 |
| Udgave nummer | 3 |
| Sider (fra-til) | 370-378 |
| ISSN | 0281-3432 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:The authors would like to thank Susanne Døssing Berntsen, Audit Project Odense, for handling and mailing the survey charts to the participants. The authors would also like to acknowledge the work done by the primary care consultants to enrol clinicians in the study. We acknowledge Søren Bie Bogh, OPEN, for valuable help in data analysis. The study was funded by the Association of Danish Physiotherapists foundation for clinical practice, the Foundation for Promotion of Chiropractic Research and Postgraduate Education and the General Practitioners’ Quality and Postgraduate Foundation in the Region of Southern Denmark. The funders did not have any influence on study design, data collection, management, analysis, interpretation or the publication of results.
Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.