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Identifying patients’ beliefs about treatments for chronic low back pain in primary care: a focus group study

Identifying patients’ beliefs about treatments for chronic low back pain in primary care: a focus group study
Identifying patients’ beliefs about treatments for chronic low back pain in primary care: a focus group study
Background: Current evidence-based guidelines for low back pain (LBP) recommend multiple diverse approaches to treatment and suggest considering patient preferences when formulating a treatment plan.

Aim: To explore patient preferences and to identify patients’ beliefs about LBP treatments.

Design: Qualitative study using focus groups.

Setting: Primary care in South-West England.

Methods: We organized 13 focus groups with a purposive sample of 75 adults with LBP. We facilitated and audio-recorded group discussions of LBP treatments and analysed the verbatim transcripts thematically.

Results: We identified 8 themes, four related to treatment beliefs and four to seeking treatment. Treatment beliefs comprised participants’ expectations and appraisals of specific treatments, which were underpinned by 4 distinct dimensions: credibility, effectiveness, concerns and individual fit. Treatment beliefs were expressed in the broader context of treatment-seeking: participants’ primary concern was to obtain a clear explanation of their LBP which went beyond a diagnostic label and provided an understanding of the cause(s) of their LBP. They described engaging in self-management activities and claimed they were willing to try anything if it might help them. Participants wanted an empathic and expert practitioner who could deliver a suitable treatment (or refer them on to someone else) and help them to negotiate the challenges of the health care system.

Conclusions: Our findings highlight the importance of helping patients develop coherent illness representations about their LBP before trying to engage them in treatment-decisions, uptake, or adherence. Addressing patients’ illness and treatment perceptions in clinical practice could improve shared decision-making and patient outcomes.
back pain, health knowledge, attitudes, practice, illness behaviour, patient preference, primary health care, qualitative research
0960-1643
e490-e498
Dima, Alexandra
91e9a8ef-49bd-4891-8e3c-61640a2666f5
Lewith, George T.
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Little, Paul S.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Foster, Nadine E.
2ca79c15-6ada-4b99-982c-f8abee19e628
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Dima, Alexandra
91e9a8ef-49bd-4891-8e3c-61640a2666f5
Lewith, George T.
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Little, Paul S.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Foster, Nadine E.
2ca79c15-6ada-4b99-982c-f8abee19e628
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928

Dima, Alexandra, Lewith, George T., Little, Paul S., Moss-Morris, Rona, Foster, Nadine E. and Bishop, Felicity L. (2013) Identifying patients’ beliefs about treatments for chronic low back pain in primary care: a focus group study. British Journal of General Practice, 63 (612), e490-e498. (doi:10.3399/bjgp13X669211).

Record type: Article

Abstract

Background: Current evidence-based guidelines for low back pain (LBP) recommend multiple diverse approaches to treatment and suggest considering patient preferences when formulating a treatment plan.

Aim: To explore patient preferences and to identify patients’ beliefs about LBP treatments.

Design: Qualitative study using focus groups.

Setting: Primary care in South-West England.

Methods: We organized 13 focus groups with a purposive sample of 75 adults with LBP. We facilitated and audio-recorded group discussions of LBP treatments and analysed the verbatim transcripts thematically.

Results: We identified 8 themes, four related to treatment beliefs and four to seeking treatment. Treatment beliefs comprised participants’ expectations and appraisals of specific treatments, which were underpinned by 4 distinct dimensions: credibility, effectiveness, concerns and individual fit. Treatment beliefs were expressed in the broader context of treatment-seeking: participants’ primary concern was to obtain a clear explanation of their LBP which went beyond a diagnostic label and provided an understanding of the cause(s) of their LBP. They described engaging in self-management activities and claimed they were willing to try anything if it might help them. Participants wanted an empathic and expert practitioner who could deliver a suitable treatment (or refer them on to someone else) and help them to negotiate the challenges of the health care system.

Conclusions: Our findings highlight the importance of helping patients develop coherent illness representations about their LBP before trying to engage them in treatment-decisions, uptake, or adherence. Addressing patients’ illness and treatment perceptions in clinical practice could improve shared decision-making and patient outcomes.

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More information

Accepted/In Press date: March 2013
Published date: July 2013
Keywords: back pain, health knowledge, attitudes, practice, illness behaviour, patient preference, primary health care, qualitative research
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 351245
URI: https://eprints.soton.ac.uk/id/eprint/351245
ISSN: 0960-1643
PURE UUID: 89af00db-4cdf-4cb2-80ae-e4d22a62ebdd
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662

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Date deposited: 17 Apr 2013 10:40
Last modified: 06 Jun 2018 12:47

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