Skip to main content

Advertisement

SpringerLink
Log in

Study of the information delivery by general practitioners and rheumatologists to patients with acute low back pain

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Providing information to patients regarding appropriate management of LBP is a crucial component of primary care and treatment of low back pain (LBP). Limited knowledge is available, however, about the information delivered by physicians to patients with low back pain. Hence, this study aimed at evaluating (1) the self-reported practices of French physicians concerning information about patients with acute LBP (2) the consistency of these practices with the COST B13 guidelines, and (3) the effects of the delivery of a leaflet summarizing the COST B13 recommendations on the management of patient information, using the following study design: 528 French physicians [319 general practitioners (GP) and 209 rheumatologists (RH)] were asked to provide demographic information, responses to a Fear Avoidance Beliefs questionnaire adapted for physicians and responses to a questionnaire investigating the consistency of their practice with the COST B13 guidelines. Half of the participants (163 GP and 105 RH) were randomized to receive a summary of the COST B13 guidelines concerning information delivery to patient with low back pain and half (156 GP and 104 RH) were not given this information. The mean age of physicians was 52.1 ± 7.6 years, 25.2% were females, 75% work in private practice, 63.1% reported to treat 10–50 patients with LBP per month and 18.2% <10 per month. The majority of the physicians (71.0%) reported personal LBP episode (7.1% with a duration superior to 3 months). Among the 18.4% (97) of the physicians that knew the COST B13 guidelines, 85.6% (83/97) reported that they totally or partially applied these recommendations in their practice. The average work (0–24) and physical activity (0–24) FABQ scores were 21.2 ± 8.4 and 10.1 ± 6.0, respectively. The consistency scores (11 questions scored 0 to 6, total score was standardized from 0 to 100) were significantly higher in the RH group (75.6 ± 11.6) than in GP group (67.2 ± 12.6; p < 0.001). The delivery of a summary of the COST B13 guidelines significantly improved the consistency score (p = 0.018). However, a multivariate analysis indicated that only GP consistency was improved by recommendations’ delivery.The results indicated that GP were less consistent with the European COST B13 guidelines on the information of patients with acute LBP than RH. Interestingly, delivery of a summary of these guidelines to GP improved their consistency score, but not that of the RH. This suggests that GP information campaign can modify the message that they deliver to LBP, and subsequently could change patient’s beliefs on LBP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Koes BW, van Tulder MW, Ostelo R, Kim Burton A, Waddell G (2001) Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 26:2504–2513

    Article  PubMed  CAS  Google Scholar 

  2. van Tulder M, Becker A, Bekkering T, Breen A, del Real MT, Hutchinson A et al (2006) Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 15(Suppl 2):S169–S191

    Article  PubMed  Google Scholar 

  3. Deyo RA, Diehl AK (1988) Psychosocial predictors of disability in patients with low back pain. J Rheumatol 15:1557–1564

    PubMed  CAS  Google Scholar 

  4. Coudeyre E, Poiraudeau S, Revel M, Kahan A, Drape JL, Ravaud P (2002) Beneficial effects of information leaflets before spinal steroid injection. Joint Bone Spine 69:597–603

    Article  PubMed  Google Scholar 

  5. Cherkin D, Deyo RA, Berg AO, Bergman JJ, Lishner DM (1991) Evaluation of a physician education intervention to improve primary care for low-back pain. I. Impact on physicians. Spine 16:1168–1172

    Article  PubMed  CAS  Google Scholar 

  6. Glenton C, Nilsen ES, Carlsen B (2006) Lay perceptions of evidence-based information—a qualitative evaluation of a website for back pain sufferers. BMC Health Serv Res 6:34

    Article  PubMed  Google Scholar 

  7. McIntosh A, Shaw CF (2003) Barriers to patient information provision in primary care: patients’ and general practitioners’ experiences and expectations of information for low back pain. Health Expect 6:19–29

    Article  PubMed  Google Scholar 

  8. Ostelo RW, Stomp-van den Berg SG, Vlaeyen JW, Wolters PM, de Vet HC (2003) Health care provider’s attitudes and beliefs towards chronic low back pain: the development of a questionnaire. Man Ther 8:214–222

    Article  PubMed  CAS  Google Scholar 

  9. Jensen IB, Bodin L, Ljungqvist T, Gunnar Bergstrom K, Nygren A (2000) Assessing the needs of patients in pain: a matter of opinion? Spine 25:2816–2823

    Article  PubMed  CAS  Google Scholar 

  10. Gremeaux V, Coudeyre E, Givron P, Herisson C, Pelissier J, Poiraudeau S et al (2007) Qualitative evaluation of the expectations of low back pain patients with regard to information gained through semi-directed navigation on the Internet. Ann Readapt Med Phys 50(348–55):339–347

    Google Scholar 

  11. Burton AK, Tillotson KM, Symonds TL, Burke C, Mathewson T (1996) Occupational risk factors for the first-onset and subsequent course of low back trouble. A study of serving police officers. Spine 21:2612–2620

    Article  PubMed  CAS  Google Scholar 

  12. Ihlebaek C, Eriksen HR (2003) Are the “myths” of low back pain alive in the general Norwegian population? Scand J Public Health 31:395–398

    Article  PubMed  Google Scholar 

  13. Roberts L, Little P, Chapman J, Cantrell T, Pickering R, Langridge J (2002) The back home trial: general practitioner-supported leaflets may change back pain behavior. Spine 27:1821–1828

    Article  PubMed  Google Scholar 

  14. Rosemann T, Joos S, Koerner T, Heiderhoff M, Laux G, Szecsenyi J (2006) Use of a patient information leaflet to influence patient decisions regarding mode of administration of NSAID medications in case of acute low back pain. Eur Spine J 15:1737–1741

    Article  PubMed  Google Scholar 

  15. Burton AK, Balague F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, et al (2006) Chapter 2. European guidelines for prevention in low back pain: November 2004. Eur Spine J; 15 Suppl 2:S136–S168

    Google Scholar 

  16. Henrotin YE, Cedraschi C, Duplan B, Bazin T, Duquesnoy B (2006) Information and low back pain management: a systematic review. Spine 31:E326–E334

    Article  PubMed  Google Scholar 

  17. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F et al (2006) Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 15(Suppl 2):S192–S300

    Article  PubMed  Google Scholar 

  18. Coudeyre E, Rannou F, Tubach F, Baron G, Coriat F, Brin S et al (2006) General practitioners’ fear-avoidance beliefs influence their management of patients with low back pain. Pain 124:330–337

    Article  PubMed  Google Scholar 

  19. Waddell G, Newton M, Henderson I, Somerville D, Main CJ (1993) A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 52:157–168

    Article  PubMed  CAS  Google Scholar 

  20. Chaory K, Fayad F, Rannou F, Lefevre-Colau MM, Fermanian J, Revel M et al (2004) Validation of the French version of the fear avoidance belief questionnaire. Spine 29:908–913

    Article  PubMed  Google Scholar 

  21. Balague F, Cedraschi C (2006) Radiological examination in low back pain patients: anxiety of the patient? Anxiety of the therapist? Joint Bone Spine 73:508–513

    Article  PubMed  Google Scholar 

  22. Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H (1995) Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 62:363–372

    Article  PubMed  CAS  Google Scholar 

  23. Vlaeyen JW, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85:317–332

    Article  PubMed  CAS  Google Scholar 

  24. Andersson GB (1999) Epidemiological features of chronic low-back pain. Lancet 354(9178):581–585

    Article  PubMed  CAS  Google Scholar 

  25. Leclerc A et al (2006) Chronic back problems among persons 30 to 64 years old in France. Spine (Phila Pa 1976) 31(4):479–484

    Google Scholar 

  26. Bishop PB, Wing PC (2006) Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. Spine J 6:282–288

    Article  PubMed  Google Scholar 

  27. Buchbinder R, Jolley D, Wyatt M (2001) Volvo award winner in clinical studies: effects of a media campaign on back pain beliefs and its potential influence on management of low back pain in general practice. Spine 26:2535–2542

    Article  PubMed  CAS  Google Scholar 

  28. Buchbinder R, Jolley D (2004) Population based intervention to change back pain beliefs: three year follow up population survey. BMJ 328:321

    Article  PubMed  Google Scholar 

  29. Chenot JF, Becker A, Leonhardt C, Keller S, Donner-Banzhoff N, Hildebrandt J et al (2008) Sex differences in presentation, course, and management of low back pain in primary care. Clin J Pain 24:578–584

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by the French Society of Rheumatology and was conducted by members of the Spine section of the French Society of Rheumatology and of the Belgian Back Society.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Belgian Back Society, Bone and Cartilage Research Unit, University of Liège, Institute of Pathology, CHU Sart-Tilman, 4000, Liège, Belgium

    Yves Henrotin

  2. Médecin Statisticien, La Poissonière, 49170, Paris, France

    Dominique Moyse

  3. Centre Médical Dupic, Lyon, France

    Thierry Bazin

  4. Multidisciplinary Pain Center, Division of Clinical Pharmacology and Toxicology, Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland

    Christine Cedraschi

  5. Hôpital Reine Hortense, Centre Hospitalier d’Aix-les-bains, Aix-les-Bains, France

    Bernard Duplan

  6. Service de Rhumatologie, Hôpital Roger Salengro, Lille, France

    Bernard Duquesnoy

  7. Centre d’Evaluation et de Traitement de la Douleur, Hôpital Saint-Antoine, Paris, France

    Francoise Laroche

  8. Université François Rabelais de Tours, Rhumatologie, 37032, Tours, France

    Jean-Pierre Valat

  9. Service de Rhumatologie, Hôpital Henri Mondor, Créteil, France

    Marc Marty

  10. Bone and Cartilage Research Unit, Institute of Pathology, Level +5, CHU Sart-Tilman, 4000, Liege, Belgium

    Yves Henrotin

Authors
  1. Yves Henrotin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dominique Moyse
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thierry Bazin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christine Cedraschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bernard Duplan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bernard Duquesnoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francoise Laroche
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jean-Pierre Valat
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marc Marty
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yves Henrotin.

Additional information

On behalf of the Section Rachis of the French Society of Rheumatology.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Henrotin, Y., Moyse, D., Bazin, T. et al. Study of the information delivery by general practitioners and rheumatologists to patients with acute low back pain. Eur Spine J 20, 720–730 (2011). https://doi.org/10.1007/s00586-010-1612-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-010-1612-6

Keywords

Search

Navigation