Managing Low Back Pain in the Primary Care Setting: The Know‐Do Gap

Scott, N. Ann; Moga, Carmen; Harstall, Christa

doi:10.1155/2010/252695

Cited by 75 publications

(63 citation statements)

References 40 publications

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“…This gap in adherence to evidence-based practice recommendations by clinicians has become popularly known as the ''know-do gap''-the gap between what is known and what is done in practice. 46,47 These national trends are contextualized by data that describe the timing of services received by patients seeking care for spinal pain in the ''real world'' of clinical practice. A recently published analysis of nationwide private insurer claims covering more than 8 million lives revealed the frontloading of treatment expenditures, even among patients with nonspecific LBP.…”

Section: Current Clinical Practicesmentioning

confidence: 99%

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Kosloff

Elton

Shulman

et al. 2013

Population Health Management

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Low back pain (LBP) has received considerable attention from researchers and health care systems because of its substantial personal, social, work-related, and economic consequences. A narrative review was conducted summarizing data about the epidemiology, care seeking, and utilization patterns for LBP in the adult US population. Recommendations from a consensus of clinical practice guidelines were compared to findings about the current state of clinical practice for LBP. The impact of the first provider consulted on the quality and value of care was analyzed longitudinally across the continuum of episodes of care. The review concludes with a description of recently published evidence that has demonstrated that favorable health and economic outcomes can be achieved by incorporating evidence-informed decision criteria and guidance about entry into conservative low back care pathways. (Population Health Management 2013;16:390-396)

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Section: Current Clinical Practicesmentioning

confidence: 99%

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Kosloff

Elton

Shulman

et al. 2013

Population Health Management

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“…For vignette 5, where imaging was indicated for a suspected fracture, 79% of physiotherapists reported they would X-ray, and 32% reported they would refer to another practitioner. Consistent with these findings, a systematic review of adherence to guidelines by primary care providers concluded that 72 -79% of physicians appear to appropriately order X-rays for acute LBP, where imaging was indicated [19].…”

Section: Discussionmentioning

confidence: 86%

“…For example, practitioner characteristics, their circumstances [27] and knowledge [19], are factors with the potential to affect guideline adherence. Furthermore, different methods for measuring behaviour (e.g.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Providing services for acute low-back pain: A survey of Australian physiotherapists

et al. 2016

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“…16 Reasons for high rates of inappropriate spine-related imaging are not clear; however, it appears to be a com bination of patient demand owing to the persistent and often recurrent nature of degenerative spinal disorders [17][18][19][20][21] as well as the limited confidence that many primary care physicians have in assessing and managing patients with chronic musculoskeletal complaints. [22][23][24] This may drive referrals for both imaging and surgical consultation owing to concerns over further management needs or missing important findings.…”

Section: Relevant Literaturementioning

confidence: 99%

Spine surgeons’ requirements for imaging at the time of referral: a survey of Canadian spine surgeons

Busse

Riva

Rampersaud

et al. 2014

cjs

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Background: Routine imaging of patients with spine-related complaints referred for surgical assessment may represent an inefficient use of technological resources. Our objective was to explore Canadian spine surgeons' requirements with respect to imaging studies accompanying spine-related referrals. Methods:We administered an 8-item survey to all 100 actively practising surgeon members of the Canadian Spine Society that inquired about demographic variables and imaging requirements for patients referred with spine-related complaints.Results: Fifty-five spine surgeons completed our survey, for a response rate of 55%. Most respondents (43; 78%) required imaging studies to accompany all spine-related referrals. The type of imaging required was highly variable, with respondents endorsing 7 different combinations. Half (47%) required magnetic resonance imaging and 38% required plain radiographs either alone or in combination with other forms of imaging. Half of the respondents refused to see 20% or more of all patients referred for spine-related complaints. Conclusion:Most Canadian spine surgeons require imaging studies to accompany spine-related referrals; however, the type and combination of studies is highly variable, and many patients who are referred are never seen (for a consultation). Standardization and optimization of imaging practices for patients with spine-related complaints referred for surgical assessment may be an important area for cost savings.Contexte : Le recours systématique aux épreuves d'imagerie chez les patients qui se plaignent de maux de dos et qui sont référés pour consultation en chirurgie pourrait constituer une utilisation inefficace des ressources technologiques. Notre objectif était d'analyser les épreuves d'imagerie demandées par les chirurgiens canadiens spécia -listes de la colonne vertébrale, suite aux demandes de consultation qui leur sont adressées pour des patients qui ont des problèmes de colonne vertébrale.Méthodes : Nous avons administré un sondage en 8 questions aux 100 chirurgiens en pratique active qui forment la Canadian Spine Society; le questionnaire portait sur des variables démographiques et sur les demandes d'épreuves d'imagerie pour les patients qui leur sont référés pour des maux de dos.

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Managing Low Back Pain in the Primary Care Setting: The Know‐Do Gap

Cited by 75 publications

References 40 publications

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Conservative Spine Care: Opportunities to Improve the Quality and Value of Care

Providing services for acute low-back pain: A survey of Australian physiotherapists

Spine surgeons’ requirements for imaging at the time of referral: a survey of Canadian spine surgeons

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