Chronic low back pain: non-clinical factors impacting on management by Irish doctors

Ir J Med Sci. 2008 Sep;177(3):257-63. doi: 10.1007/s11845-008-0174-7. Epub 2008 Jun 27.

Abstract

Introduction: General practitioners and consultants in the Republic of Ireland manage patients with chronic low back pain (LBP), but little is known about the non-clinical factors that impact on their management.

Aim: To establish the non-clinical factors that impact on the management of chronic LBP by a cohort of general practitioners and consultants.

Methods: Using a multiple case study design, semi-structured interviews were conducted with general practitioners (n = 7) and consultants (n = 7). Interviews were transcribed and analysed qualitatively.

Results: Two main themes emerged: policy factors (the health care system, the medico-legal system), and patient factors (need for reassurance, lack of patient adherence).

Conclusions: These factors operate at national and local levels. Nationally, they underscore the lack of resources, and the impact of the medico-legal system. Local issues include changing practice by reassuring patients using evidence-based biopsychosocial strategies to maximise patient care and reduce healthcare costs.

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Chronic Disease
  • Female
  • Health Policy
  • Humans
  • Interviews as Topic
  • Ireland / epidemiology
  • Low Back Pain / epidemiology
  • Low Back Pain / therapy*
  • Male
  • Patient Compliance
  • Physician-Patient Relations
  • Physicians, Family
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Statistics, Nonparametric