Managing low back pain in the primary care setting: the know-do gap
N Ann Scott1, Carmen Moga, Christa Harstall
1Institute of Health Economics, Edmonton, Alberta. capstone@shaw.ca
Pain Research & Management
|December 18, 2010
Summary
Primary care practitioners show significant knowledge gaps in diagnosing and treating low back pain (LBP). This study identifies these gaps to improve LBP management and guideline implementation in Alberta.
Area of Science:
- Primary Care Medicine
- Evidence-Based Practice
- Pain Management
Background:
- Low back pain (LBP) is a prevalent condition in primary care settings.
- Effective management of LBP requires adherence to evidence-based guidelines.
- Identifying knowledge gaps is crucial for improving clinical practice.
Purpose of the Study:
- To identify knowledge gaps in the diagnosis and treatment of acute and chronic low back pain (LBP) among primary care practitioners.
- To inform the development of a survey for assessing LBP management knowledge in Alberta.
- To identify barriers to implementing a multidisciplinary LBP guideline.
Main Methods:
- Systematic literature search of English language studies published between 1996 and 2008.
- Included studies compared primary care practice patterns with guideline recommendations.
- Qualitative synthesis of data from 14 identified studies.
Main Results:
- Knowledge gaps identified in primary care practitioners regarding red flag assessment and diagnostic imaging.
- Gaps noted in advising on sick leave, activity, and prescribing certain medications (e.g., muscle relaxants, opioids).
- Deficiencies found in recommending various treatments like physiotherapy and spinal manipulation.
Conclusions:
- A significant 'know-do' gap exists in primary care for LBP diagnosis and treatment.
- Findings will guide the creation of a survey tool for Alberta practitioners.
- Results will inform a dissemination strategy for a local LBP guideline to target specific knowledge deficits.
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