Back pain management in primary care: patients' and doctors' expectations

Expectations may be a key element for improving quality of health care, yet several barriers interfere with understanding and optimising expectations in back pain primary care.

To review the literature related to expectations, back pain patients' and doctors' expectations and sources of unmatched expectations.

Review of qualitative and quantitative studies investigating back pain management in primary care settings, and eliciting patients' and/or doctors' pre-visit or post-visit expectations.

Reviewing the literature reveals that expectations are defined and conceptualised in various ways, with several terms used interchangeably, which suggests a lack of clear definition and conceptual framework. Patients have a wide range of specific expectations for care, which can be measured, and may play a vital role in their satisfaction: doctors also seem to have their own expectations. However, studies of such expectations are scarce and there is a lack of valid measurement tools to capture such aspects.

Shortcomings in literature included the use of different meanings and definitions for expectations, which interfered with understanding the results of previous research. Previous studies focused on patients' general rather than condition-specific expectations; no study explored doctors' expectations or the congruency between patients' and doctors' back pain-specific expectations.

There is a need for standardisation of definition in expectations research and a valid measurement tool that is condition specific. Understanding patients' and doctors' expectations may be a key factor for improving quality of care, in terms of both process and outcome.