Featured Research

from universities, journals, and other organizations

Usual care often not consistent with clinical guidelines for low back pain

Date:
February 8, 2010
Source:
JAMA and Archives Journals
Summary:
Australian general practitioners often treat patients with low back pain in a manner that does not appear to match the care endorsed by international clinical guidelines, according to a new study.

Australian general practitioners often treat patients with low back pain in a manner that does not appear to match the care endorsed by international clinical guidelines, according to a report in the February 8 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Low back pain is estimated to be the seventh most common reason for a general practitioner visit in Australia and the fifth most common in the United States, according to background information in the article. An overwhelming body of literature on the management of low back pain -- more than 1,200 published trials and systematic reviews -- makes practice guidelines an efficient way for clinicians to base their care on the best evidence. A previous review concluded that guidelines in 11 countries around the world provide similar recommendations for assessment and management of low back pain.

"Given the proliferation of clinical practice guidelines outlining best practice, it is timely to consider how closely usual care aligns with guideline recommendations," write Christopher M. Williams, M.App.Sc., of The George Institute for International Health, Camperdown, Australia, and colleagues. The authors assessed the care provided for new episodes of low back pain during 3,533 patient visits to general practitioners in Australia between 2001 and 2008. These visits were mapped to key recommendations in treatment guidelines; in addition, data were compared for two three-year periods before and after the release of Australian national guidelines in 2004.

"Our findings show that key aspects of the usual care provided to patients do not align with the care recommended in international evidence-based guidelines," the authors write. For example, although guidelines discourage the use of imaging, more than one-quarter of patients were referred for radiology, computed tomography or similar tests.

Only 20.5 percent of patients received advice and 17.7 percent received simple pain-relieving medications, both of which are recommended as part of initial care for low back pain. Instead of the safer and equally effective acetaminophen, patients were more often prescribed non-steroidal anti-inflammatory drugs (37.4 percent) and opioids (19.6 percent).

In addition, patterns of care did not change significantly following the release of local guidelines, the authors note.

"Understanding why general practitioners do not follow key treatment recommendations of guidelines is an important prerequisite to improving this situation," they write. Evidence suggests that the views of both patients and clinicians, and potentially miscommunication between the two, contribute to departures from guideline-based care.

"In the back pain field, there has been extensive activity in the past two decades focusing on the evaluation of new and existing therapies within clinical trials and systematic reviews," the authors conclude. "Arguably, we need a parallel line of research that focuses on how best to encourage provision of evidence-based treatments. Educational outreach with broader societal focus may enhance guideline dissemination and reduce the burden of low back pain."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Christopher M. Williams; Christopher G. Maher; Mark J. Hancock; James H. McAuley; Andrew J. McLachlan; Helena Britt; Salma Fahridin; Christopher Harrison; Jane Latimer. Low Back Pain and Best Practice Care: A Survey of General Practice Physicians. Arch Intern Med, 2010; 170 (3): 271-277 [link]

Cite This Page:

JAMA and Archives Journals. "Usual care often not consistent with clinical guidelines for low back pain." ScienceDaily. ScienceDaily, 8 February 2010. <www.sciencedaily.com/releases/2010/02/100208185210.htm>.
JAMA and Archives Journals. (2010, February 8). Usual care often not consistent with clinical guidelines for low back pain. ScienceDaily. Retrieved September 18, 2014 from www.sciencedaily.com/releases/2010/02/100208185210.htm
JAMA and Archives Journals. "Usual care often not consistent with clinical guidelines for low back pain." ScienceDaily. www.sciencedaily.com/releases/2010/02/100208185210.htm (accessed September 18, 2014).

Share This



More Health & Medicine News

Thursday, September 18, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Artificial Sweetener Could Promote Diabetes

Artificial Sweetener Could Promote Diabetes

Newsy (Sep. 17, 2014) Doctors once thought artificial sweeteners lacked the health risks of sugar, but a new study says they can impact blood sugar levels the same way. Video provided by Newsy
Powered by NewsLook.com
Ebola Vaccine Trial Gets Underway at Oxford University

Ebola Vaccine Trial Gets Underway at Oxford University

AFP (Sep. 17, 2014) A healthy British volunteer is to become the first person to receive a new vaccine for the Ebola virus after US President Barack Obama called for action against the epidemic and warned it was "spiralling out of control." Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Obesity Rates Steady Even As Americans' Waistlines Expand

Obesity Rates Steady Even As Americans' Waistlines Expand

Newsy (Sep. 17, 2014) Researchers are puzzled as to why obesity rates remain relatively stable as average waistlines continue to expand. Video provided by Newsy
Powered by NewsLook.com
President To Send 3,000 Military Personnel To Fight Ebola

President To Send 3,000 Military Personnel To Fight Ebola

Newsy (Sep. 16, 2014) President Obama is expected to send 3,000 troops to West Africa as part of the effort to contain Ebola's spread. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins