Physicians' determinants for sick-listing LBP patients: a systematic review

Area of Science:

• Occupational Medicine
• Public Health

Background:

• Sick-listing is a complex process involving multiple stakeholders.
• Physicians' decision-making for sick-listing patients with low back pain (LBP) is not well understood.

Purpose of the Study:

• To systematically review and describe the determinants physicians use when deciding to sick-list patients with LBP.

Main Methods:

• Systematic literature review of Medline, EMBASE, PsychInfo, and Cochrane Central databases.
• Inclusion of studies on workers with LBP where sick-listing was an outcome.
• Critical appraisal and synthesis of findings into internal and external physician-related factors.

Main Results:

• Eleven studies met inclusion criteria, identifying key determinants.
• Internal factors: physicians' fear avoidance and distress regarding LBP complexity.
• External factors: patient expectations, clinical findings, employer support, and modified work availability.

Conclusions:

• Physicians require enhanced knowledge of modified work options and LBP management.
• The patient-physician relationship and physician empathy may impede adherence to LBP management guidelines during sick-listing.
• Future research should address these specific issues in sick-listing practices.