Usual care for low back pain and barriers to best practice: A cross-sectional study in Danish general practice.

IF 1.5 Q3 RHEUMATOLOGY
Bodil Al-Mashhadi Arnbak, Tue Secher Jensen, Rikke Arnborg Lund, Jan Hartvigsen, Jens Søndergaard, Janus Laust Thomsen, John Sahl Andersen, Anne Møller, Birgitte Nørgaard, Camilla Blach Rossen, Alice Kongsted
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引用次数: 0

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.

腰背痛的常规护理和最佳实践的障碍:丹麦全科医生横断面研究。
目的描述目前丹麦全科医疗中腰背痛(LBP)护理的内容、患者的自我管理活动以及临床医生在提供最佳护理时遇到的障碍:这项横断面观察研究纳入了2022年8月至2023年6月期间在丹麦全科诊所就诊的成年腰背痛患者。患者报告的信息包括人口统计学、疼痛强度、病史、治疗方法和自我管理策略。临床医生提供了每次会诊的具体数据,详细说明了这些会诊的内容以及具体病例中最佳实践的障碍:这项研究有来自 42 家全科诊所的 71 名临床医生参与,共获得 294 名患者的患者报告数据和 283 次(95%)会诊的临床医生报告数据。纳入研究的患者平均年龄为 53 岁,56% 为女性,31% 在过去 3 个月中曾因腰背痛休过病假。此外,44%的患者在前一个月内曾见过两名或两名以上的医护人员,55%的患者曾因枸杞痛接受过影像诊断,81%的患者表示使用过任何类型的镇痛药,14%的患者表示使用过阿片类药物。大多数人(91%)表示曾通过自我管理来缓解疼痛。根据临床医生或患者的报告,会诊通常包括体格检查(84%)、疼痛原因信息(74%)和管理建议(68%)。一般来说,临床医生比患者更经常报告会诊内容。84%的病例中,临床医生报告提供了最佳治疗方法,而时间限制(23%)和患者期望(10%)是最常见的障碍:本研究详细介绍了丹麦全科医生对腰椎间盘突出症的管理。它揭示了患者参与、不同管理策略以及患者和临床医生对护理内容的不同看法等复杂情况。患者经常参与自我管理活动,而临床医生在提供最佳实践护理时几乎没有遇到什么障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
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