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Factors impacting on doctors’ management of acute low back pain: A systematic review
Author(s) -
Fullen Brona M.,
Baxter G. David,
O'Donovan Barry G.G.,
Doody Catherine,
Daly Leslie E.,
Hurley Deirdre A.
Publication year - 2009
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2008.11.013
Subject(s) - cinahl , medicine , medline , referral , low back pain , physical therapy , guideline , data extraction , family medicine , alternative medicine , psychological intervention , nursing , pathology , political science , law
The aim of this review was to determine the factors that impact on doctors’ management of patients with acute low back pain. A methodological assessment of databases (Medline, EMBASE, Psychinfo, BIOSIS, CINAHL, and the Cochrane Central Register of Controlled Trials) identified papers which were screened for inclusion criteria by two independent reviewers. Data were extracted from accepted papers, and the internal validity and strength of the evidence were determined using valid and reliable scales. The search generated a total of 28 papers [quantitative ( n =27), qualitative ( n =1) methodologies]. Themes were identified from the accepted papers: education ( n =18), knowledge of clinical guidelines and impact on management ( n =7), and doctors’ demographics ( n =4). There was consistent evidence that doctors did not adhere to clinical guidelines when performing a spinal assessment. There was inconsistent evidence that education increased adherence with acute LBP guideline recommendations in terms of referral rates to physiotherapy, for investigations, to secondary care and for maintaining patients at work. Strategies to address the factors impacting on doctors’ management of acute LBP are required; these would lead to improvement in patient outcomes and reduce healthcare costs.