Usual Care for Low Back Pain and Barriers to Best Practice: A Cross-sectional Study in Danish General Practice

  • Bodil Al-Mashhadi Arnbak*
  • , Tue Secher Jensen
  • , Rikke Lund Arnborg
  • , Jan Hartvigsen
  • , Jens Søndergaard
  • , Janus Laust Thomsen
  • , John Sahl Andersen
  • , Anne Møller
  • , Birgitte Nørgaard
  • , Camilla Blach Rossen
  • , Alice Kongsted
  • *Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

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Abstract

Objectives: To describe the current content of low back pain (LBP) care in Danish general practice, the patients' self-management activities, and the clinicians' experienced barriers to providing best practice care. Methods: This cross-sectional observational study included adults with LBP seeking care in Danish general practice from August 2022 to June 2023. Patient-reported information included demographics, pain intensity, medical history, treatments, and self-management strategies. Clinicians provided data specific to each consultation, detailing the content of these consultations, and barriers to best practice in the specific cases. Results: The study involved 71 clinicians from 42 general practice clinics, with patient-reported data from 294 patients, and clinician-reported data from 283 (95%) consultations. The mean age for the included patients was 53 years, 56% were female, and 31% had been on sick leave for LBP during the previous 3 months. Moreover, 44% had seen two or more healthcare professionals in the previous month, 55% had previously undergone diagnostic imaging for LBP, 81% reported using any type of analgesics, and 14% reported using opioids. The majority (91%) reported engaging in self-management activities to alleviate pain. Consultations typically included a physical examination (84%), information about the cause of the pain (74%), and management advice (68%), as reported by clinicians or patients. In general, clinicians reported consultation elements more frequently than patients. Clinicians reported providing best practice care in 84% of cases, with time constraints (23%) and patient expectations (10%) being the most common barriers. Conclusions: This study provides detailed insights into the management of LBP in Danish general practice. It reveals a complex landscape of patient engagement, varying management strategies, and differing perceptions of care content between patients and clinicians. Patients were often engaged in self-management activities and clinicians reported few barriers to providing best practice care.

Original languageEnglish
Article numbere1911
JournalMusculoskeletal Care
Volume22
Issue2
ISSN1478-2189
DOIs
Publication statusPublished - Jun 2024

Keywords

  • general practice
  • healthcare
  • low back pain
  • self-management

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