Primary care physicians’ attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study

Rodondi, Pierre-Yves; Dubois, Julie; Bill, Anne-Sylvie; Koutaïssoff, Daria; Ros, Jenny; Aveni, Éléonore; Pasquier, Jérôme; Herzig, Lilli; Décosterd, Isabelle; Burnand, Bernard

doi:10.1371/journal.pone.0204613

Cited by 11 publications

(9 citation statements)

References 51 publications

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“…The sociodemographic profile of the study participants revealed that the majority were young women who had graduated less than 5 years earlier, mainly from public universities, and whose current area of activity was public PHC. In this context, in a study conducted with primary care physicians in Switzerland, it was found that women and young people are more likely to recommend integrative practices, 8 a finding compatible with the profile raised by this study. It was also verified that 81.8% of the respondents underwent the Introduction to Acupuncture course while attending medical residency in family medicine.…”

Section: Discussionsupporting

confidence: 87%

“…Few studies have investigated the profile of medical doctors that underwent acupuncture training or provided follow-up data of the repercussion of acupuncture in a physician’s clinical practice. 8–12 There is a scarcity of literature that addresses the implementation of acupuncture in the context of primary care 13 or that describes experiences of complementary acupuncture education for PHC physicians and FCM residents. 14 Therefore, the aim of this study was to analyze the profile of acupuncture use by physicians who underwent the Introduction to Acupuncture course offered in the public health system of the city of Florianópolis, Brazil.…”

Section: Introductionmentioning

confidence: 99%

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Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

et al. 2020

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Background: An introductory acupuncture course has been offered to primary health care physicians and family medicine residents in southern Brazil since 2011. Objective: To analyze the profile of acupuncture utilization of primary care physicians who completed an introductory course of acupuncture between 2011 and 2018. Method: A survey using an electronic questionnaire was sent to all 119 physicians who completed the course. Results: Fifty-five physicians answered the questionnaire. The majority of them reported continuation of the practice of acupuncture in scheduled appointments and on spontaneous demand. The most commonly used principles of point selection were traditional acupuncture point function, myofascial trigger point needling and point protocols. As barriers to the practice of acupuncture, time limitation and inadequate physical space were predominant. The participants described the problem-solving potential of the procedure and good patient acceptance as facilitators. The most common problems treated with acupuncture were musculoskeletal pain, and mood and anxiety disorders. A reduction in referrals to specialists and reduced prescription of pain medications were also reported. Most physicians answered that they often combined acupuncture with other medications or associated acupuncture with other complementary practices. The main adverse events reported by the participants were vascular trauma and fainting. Conclusion: Most primary care physicians who completed the introductory course and answered the survey still used acupuncture in their routine, primarily for the management of musculoskeletal conditions and mental health conditions. These physicians reported reductions in specialist referrals and prescription of pain medication after integrating basic acupuncture skills into primary care practice.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

et al. 2020

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“…In terms of skill sets of recruited healthcare professionals, physiotherapists, psychologists and nurses were the most common intervention facilitators, potentially indicative of a need to focus on education around physical activity, mental health (notably, cognitive behavioural strategies) and general lifestyle changes. Communication between participants and these three types of healthcare professionals is likely to reshape beliefs and behaviour of people with chronic pain, an outcome identified in previous research involving various healthcare professionals and health conditions such as low back pain and palliative care [28, 77–80].…”

Section: Discussionmentioning

confidence: 99%

Multi-disciplinary interventions for chronic pain involving education: A systematic review

et al. 2019

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BackgroundThere have been growing recommendations to include education in multi-disciplinary interventions targeting chronic pain management. However, effects of this strategy on short- and long-term self-management of chronic pain, remain largely unexplored.Objectives1. To provide an updated overview of studies that report on the impact of patient education in multi-disciplinary interventions, on self-management of chronic pain; 2. To explore associations between education and chronic pain self-management techniques; and 3. To identify the format and duration of suitable chronic pain interventions targeted at patient self-management.MethodsDesign: Narrative systematic literature review of randomised or controlled study designs. Data Sources: PubMed, CINAHL, EMBASE, PsycINFO. Participants: Adult patients with chronic pain of any aetiology participating in multi-disciplinary programs that included education. Main outcome measures: Assessments of level of pain, function, quality of life, self-efficacy, self-management, and any other relevant assessments. Study Appraisal and Synthesis Methods: PRISMA guidelines, Cochrane Risk of Bias tool, and TIDieR model.ResultsDatabase searching identified 485 potential papers. After removal of duplicates, and irrelevant articles by title and abstract, 120 full-text articles were reviewed and 27 studies were included in this systematic review. Studies were predominantly from the United States (n = 8; 29.6%). Over one hundred outcome measures were identified across all studies, with significant variation also observed in terms of how chronic pain duration was defined, and how education was delivered to participants. Overall, positive benefits of education were reported.ConclusionsEducation, as part of multi-disciplinary programs, is likely to improve self-management and self-efficacy in people with chronic pain of any aetiology. Heterogeneity in terms of: chronic pain duration; educational resources; healthcare professionals; and outcome measures, were identified as limitations. Further research, in the form of Randomised Controlled Trials addressing these limitations, is recommended.

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“…While the mention of ‘acupuncture’ can connote ‘complementary’ or ‘alternative’ medicine to some PCPs, others may already view acupuncture as part of usual care for LBP. 21 PCPs who have used acupuncture themselves are more likely to recommend acupuncture to their patients, 22 so it may be more important to disseminate information to those who have no personal experience with acupuncture. It is unclear whether communicating acupuncture as an “alternative” is detrimental to the adoption of acupuncture by PCPs and other stakeholders, but could be tested.…”

Section: Acupuncture For Lbp In Younger Adultsmentioning

confidence: 99%

The Intersection of Dissemination Research and Acupuncture: Applications for Chronic Low Back Pain

Roseen

Purtle

Zhang

et al. 2021

Glob Adv Health Med

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Background Dissemination research is the study of distributing information and intervention materials to a specific clinical practice or public health audience. Acupuncture, a healthcare practice involving the stimulation of certain body points, often with thin needles, is considered an evidence-based treatment for low back pain (LBP), but is underutilized in the United States. Body: We will use the example of acupuncture for LBP to identify opportunities to leverage dissemination research to increase utilization of acupuncture. Deficits in the awareness or knowledge of acupuncture may limit its adoption by patients and other stakeholders. Thus, we summarize methods to gather data on stakeholder awareness and knowledge of acupuncture for LBP, i.e., audience research. Engaging multiple stakeholder audiences (e.g., health system leaders, primary care providers, patients), is needed to generate knowledge on promising dissemination strategies for each audience. Audience segmentation is important for identifying population subgroups for whom adoption of acupuncture may require a more intensive or tailored dissemination strategy. To illustrate potential audience ‘segments’, our research discussion focused on developing dissemination strategies by age (i.e., older adults – those age 65 years or older, and younger adults – those under age 65 ). This decision was prompted by Medicare’s recent policy covering acupuncture for chronic LBP. We leverage current knowledge of barriers and facilitators of acupuncture use to discuss how further tailoring of dissemination strategies might optimize adoption of acupuncture in both groups of adults. Experimental study designs could then be used to compare the effectiveness of such strategies to increase awareness, knowledge, or adoption of acupuncture. Conclusions: Conducting dissemination research may improve awareness and knowledge of acupuncture, and ultimately the adoption of acupuncture in biomedical settings. We anticipate that the concepts highlighted in this manuscript will also be helpful for those disseminating information about other complementary and integrative health approaches.

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Primary care physicians’ attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study

Cited by 11 publications

References 51 publications

Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

Multi-disciplinary interventions for chronic pain involving education: A systematic review

The Intersection of Dissemination Research and Acupuncture: Applications for Chronic Low Back Pain

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